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Background <p>This study investigates the clinical presentations, diagnostic approaches, and treatment outcomes of pulmonary cryptococcosis (PC) in non-HIV patients in Fujian Province, and explores the correlation between immunological status and clinical features.</p> Methods <p>A prospective, multicenter cohort study was conducted from April 2017 to March 2022, involving 234 PC patients from 47 hospitals in nine prefecture-level cities in southeastern China’s Fujian Province.</p> Results <p>The study included 145 male and 89 female PC patients, average age 50.66 ± 14.11&#xa0;years. Immunological status varied: 115 immunocompetent, 17 with potential immunodeficiency due to certain comorbidities, 69 with mild-to-moderate immunodeficiency, and 33 with severe immunodeficiency. Diabetes mellitus was the most common comorbidity. The prevalence of PC is higher in Eastern Fujian (51.7%). 18.4% of patients were exposed to birds/pigeons droppings prior to admission. 37.6% of patients were asymptomatic. Cough and expectoration were common symptoms. Radiologically, multiple lesions with subpleural and lower lobe involvement were typical. The Cryptococcus capsular antigen (CrAg) test showed a sensitivity of 94.9%. Fluconazole was the primary treatment (87.0%), followed by voriconazole. At final follow-up, 85.4% of patients had recovered or improved.</p> Conclusions <p>PC incidence in non-HIV-infected adults in Fujian is higher in males. Most patients were immunocompetent and from eastern Fujian, with few significant environmental exposures. Clinical and radiological findings were non-specific, highlighting diagnostic challenges. The CrAg test is a valuable diagnostic tool. Treatment with fluconazole and voriconazole resulted in favorable outcomes.</p>

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A multicenter prospective clinical cohort study of pulmonary cryptococcosis in adult non-HIV-infected patients in a southeastern province of China

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月13日

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  • Chen Meiyan,
  • Chen Shuyang,
  • Wang Meng,
  • Wang Huijuan,
  • Zeng Shengyuan,
  • Zhuang Liying,
  • Lai Guoxiang,
  • Yu Zongyang,
  • You Yanjing,
  • Xie Baosong,
  • Yao Xiujuan,
  • Chen Xiangqi,
  • Lin Lan,
  • Lin Qunying,
  • Hu Yuxiong,
  • Xu Liyu,
  • Li Xiaohua,
  • Chen Xiaohong,
  • Wu Danmei,
  • Chen Gongping,
  • Liu Kaixiong,
  • She Hui,
  • Lin Li,
  • Yu Guoqing,
  • Wen Wen

摘要

Background

This study investigates the clinical presentations, diagnostic approaches, and treatment outcomes of pulmonary cryptococcosis (PC) in non-HIV patients in Fujian Province, and explores the correlation between immunological status and clinical features.

Methods

A prospective, multicenter cohort study was conducted from April 2017 to March 2022, involving 234 PC patients from 47 hospitals in nine prefecture-level cities in southeastern China’s Fujian Province.

Results

The study included 145 male and 89 female PC patients, average age 50.66 ± 14.11 years. Immunological status varied: 115 immunocompetent, 17 with potential immunodeficiency due to certain comorbidities, 69 with mild-to-moderate immunodeficiency, and 33 with severe immunodeficiency. Diabetes mellitus was the most common comorbidity. The prevalence of PC is higher in Eastern Fujian (51.7%). 18.4% of patients were exposed to birds/pigeons droppings prior to admission. 37.6% of patients were asymptomatic. Cough and expectoration were common symptoms. Radiologically, multiple lesions with subpleural and lower lobe involvement were typical. The Cryptococcus capsular antigen (CrAg) test showed a sensitivity of 94.9%. Fluconazole was the primary treatment (87.0%), followed by voriconazole. At final follow-up, 85.4% of patients had recovered or improved.

Conclusions

PC incidence in non-HIV-infected adults in Fujian is higher in males. Most patients were immunocompetent and from eastern Fujian, with few significant environmental exposures. Clinical and radiological findings were non-specific, highlighting diagnostic challenges. The CrAg test is a valuable diagnostic tool. Treatment with fluconazole and voriconazole resulted in favorable outcomes.