case_images: PMC9672815_01
case_images: CT findings of the three patients at different periods. (A) The enhanced CT scan of patient 1 on the second day of admission showed a right lower lung lesion. (B) 1 month after discharge, CT reexamination of patient 1 showed a reduction of the lesion. (C) 3 months after discharge, CT reexamination of patient 1 showed a continuous reduction of the lesion. (D) CT scan of patient 2 on admission showed lung lesions. (E) 2 months after discharge, CT reexamination of patient 2 showed a reduction of the lesion. (F) 4 months after discharge, CT reexamination of patient 2 showed a smaller lesion than the previous one. (G,J) CT scan of patient 3 at the hospital showed lung lesions. (H,K) 6 months later, the patient was reexamined by CT. (I,L) 9 months later, the patient was reexamined by CT.
case_images: fpubh-10-971511-g0001.jpg
case_images: PMC9672815_03_fpubh-10-971511-g0001.jpg
case_images: F1
case_images: CT (another hospital): multiple nodules of various sizes could be seen in the middle and upper lobe of the right lung, and some of the edges were irregular. CT (our hospital): Multiple tiny nodules and mass shadows in the right upper lung, considering infection (Figures 1G,J). Compound Sulfamethoxazole based on Rifamycin Sodium Injection, moxifloxacin, and the patient was discharged after the symptoms improved. CT scans taken 6 and 9 months later revealed a steady improvement (Figures 1H,I,K,L).
case_images: Histopathological examination results of three patients. (A) Granulomatous inflammation, with more spore-like material, Manifestations of fungal infection, tends to cryptococcus neoformans. Special staining: PAS (+), AFB (-), GMS (+). (B) Lung tissue chronic inflammation, local multinucleated giant cells, intracellular spore-like structure, Special staining: PAS (+), AFB (-), GMS (+). Combining the results of the special stain and the clinical features of the patient, the patient was considered to have a cryptococcal infection of the lung. (C) Combined with the morphology and special staining results, Tendency to fungal infections: Cryptococcusand Talaromyces marneffei infection. Pneumocystis Pneumocystis jiroveciiinfection cannot be ruled out. Special dyeing: Mucus red card (+), GMS (+), PAS (+).
case_images: fpubh-10-971511-g0002.jpg
case_images: PMC9672815_03_fpubh-10-971511-g0002.jpg
case_images: F2
case_images: Special dyeing: Mucus red card (+), GMS (+), PAS (+) (Figure 2C). mNGS (2020/01/11): Cryptococcus neoformans. mNGS results showed that the sequence number of Cryptococcus was 2,680.
case_images: PMC9672815_02
case_images: CT findings of the three patients at different periods. (A) The enhanced CT scan of patient 1 on the second day of admission showed a right lower lung lesion. (B) 1 month after discharge, CT reexamination of patient 1 showed a reduction of the lesion. (C) 3 months after discharge, CT reexamination of patient 1 showed a continuous reduction of the lesion. (D) CT scan of patient 2 on admission showed lung lesions. (E) 2 months after discharge, CT reexamination of patient 2 showed a reduction of the lesion. (F) 4 months after discharge, CT reexamination of patient 2 showed a smaller lesion than the previous one. (G,J) CT scan of patient 3 at the hospital showed lung lesions. (H,K) 6 months later, the patient was reexamined by CT. (I,L) 9 months later, the patient was reexamined by CT.
case_images: fpubh-10-971511-g0001.jpg
case_images: PMC9672815_03_fpubh-10-971511-g0001.jpg
case_images: F1
case_images: CT (another hospital): multiple nodules of various sizes could be seen in the middle and upper lobe of the right lung, and some of the edges were irregular. CT (our hospital): Multiple tiny nodules and mass shadows in the right upper lung, considering infection (Figures 1G,J). Compound Sulfamethoxazole based on Rifamycin Sodium Injection, moxifloxacin, and the patient was discharged after the symptoms improved. CT scans taken 6 and 9 months later revealed a steady improvement (Figures 1H,I,K,L).
case_images: Histopathological examination results of three patients. (A) Granulomatous inflammation, with more spore-like material, Manifestations of fungal infection, tends to cryptococcus neoformans. Special staining: PAS (+), AFB (-), GMS (+). (B) Lung tissue chronic inflammation, local multinucleated giant cells, intracellular spore-like structure, Special staining: PAS (+), AFB (-), GMS (+). Combining the results of the special stain and the clinical features of the patient, the patient was considered to have a cryptococcal infection of the lung. (C) Combined with the morphology and special staining results, Tendency to fungal infections: Cryptococcusand Talaromyces marneffei infection. Pneumocystis Pneumocystis jiroveciiinfection cannot be ruled out. Special dyeing: Mucus red card (+), GMS (+), PAS (+).
case_images: fpubh-10-971511-g0002.jpg
case_images: PMC9672815_03_fpubh-10-971511-g0002.jpg
case_images: F2
case_images: Special dyeing: Mucus red card (+), GMS (+), PAS (+) (Figure 2C). mNGS (2020/01/11): Cryptococcus neoformans. mNGS results showed that the sequence number of Cryptococcus was 2,680.
case_images: PMC9672815_03
case_images: CT findings of the three patients at different periods. (A) The enhanced CT scan of patient 1 on the second day of admission showed a right lower lung lesion. (B) 1 month after discharge, CT reexamination of patient 1 showed a reduction of the lesion. (C) 3 months after discharge, CT reexamination of patient 1 showed a continuous reduction of the lesion. (D) CT scan of patient 2 on admission showed lung lesions. (E) 2 months after discharge, CT reexamination of patient 2 showed a reduction of the lesion. (F) 4 months after discharge, CT reexamination of patient 2 showed a smaller lesion than the previous one. (G,J) CT scan of patient 3 at the hospital showed lung lesions. (H,K) 6 months later, the patient was reexamined by CT. (I,L) 9 months later, the patient was reexamined by CT.
case_images: fpubh-10-971511-g0001.jpg
case_images: PMC9672815_03_fpubh-10-971511-g0001.jpg
case_images: F1
case_images: CT (another hospital): multiple nodules of various sizes could be seen in the middle and upper lobe of the right lung, and some of the edges were irregular. CT (our hospital): Multiple tiny nodules and mass shadows in the right upper lung, considering infection (Figures 1G,J). Compound Sulfamethoxazole based on Rifamycin Sodium Injection, moxifloxacin, and the patient was discharged after the symptoms improved. CT scans taken 6 and 9 months later revealed a steady improvement (Figures 1H,I,K,L).
case_images: Histopathological examination results of three patients. (A) Granulomatous inflammation, with more spore-like material, Manifestations of fungal infection, tends to cryptococcus neoformans. Special staining: PAS (+), AFB (-), GMS (+). (B) Lung tissue chronic inflammation, local multinucleated giant cells, intracellular spore-like structure, Special staining: PAS (+), AFB (-), GMS (+). Combining the results of the special stain and the clinical features of the patient, the patient was considered to have a cryptococcal infection of the lung. (C) Combined with the morphology and special staining results, Tendency to fungal infections: Cryptococcusand Talaromyces marneffei infection. Pneumocystis Pneumocystis jiroveciiinfection cannot be ruled out. Special dyeing: Mucus red card (+), GMS (+), PAS (+).
case_images: fpubh-10-971511-g0002.jpg
case_images: PMC9672815_03_fpubh-10-971511-g0002.jpg
case_images: F2
case_images: Special dyeing: Mucus red card (+), GMS (+), PAS (+) (Figure 2C). mNGS (2020/01/11): Cryptococcus neoformans. mNGS results showed that the sequence number of Cryptococcus was 2,680.