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Serum Cryptococcal Antigen Confirmed Pulmonary Cryptococcosis in an Immune-competent Adult Firstly Misdiagnosed of Tuberculosis from a Lung Biopsy: a Case Report and Literature Review by Yan L. Ge, Cong H. Liu, Meng H. Wang, Zhen Z. Li, Hong L. Li, Zi Y. Cui, Hai F. Zhang, Xiao Y. Zhu, Xue Zhang, Hua L. Yu, Ai S. Fu, Hong Y. Wang

Background: Cryptococcal pneumonia is an uncommon lesion in immune-competent adults. Histological evidence of Cryptococcus neoformans is a gold criterion for diagnosis. Here we report a case firstly misdiagnosed as tuberculosis from a lung biopsy.
Methods: Chest computed tomography (CT) scan and CT-guided puncture were performed for diagnosis and blood tests explored for the latent etiology.
Results: Chest CT scan images showed multiple nodules in the left peripheral lower lobe. Histopathology demonstrated multiple granulomatous inflammatory response lacking evidence of Cryptococcus neoformans, acid-fast staining was negative, serum cryptococcal antigen was positive.
Conclusions: Serum cryptococcal antigen has high specificity in cryptococcal pneumonia.

DOI: 10.7754/Clin.Lab.2018.180616