CRYPTOCOCCAL PNEUMONIA IN PATIENTS WITH THE ACQUIRED-IMMUNODEFICIENCY-SYNDROME

Infection with Cryptococcus neoformans occurs with increased frequency in patients with the human immunodeficiency virus (HIV). Despite the lungs being the portal of entry for the fungus the commonest presentat ion is with meningitis: Cryptococcal broncho pulmonary infection occur s less commonly, The chest radiographs of fourteen HIV positive patien ts with cryptococcal pneumonia were reviewed, The commonest radiograph ic abnormalities mere interstitial infiltrates, (nine patients) and fo cal or widespread alveolar consolidation (seven patients), Ground glas s shadowing, not previously described in cryptococcal pneumonia, occur red in sis radiographs, miliary nodules in one, lymphadenopathy in fou r, and small pleural effusions in three. Two patients had a normal che st radiograph. In contrast to previous reports, we found alveolar cons olidation and ground glass shadowing to be common and nodules and cavi tation to be rare, Cryptococcal pneumonia should be considered in the differential diagnosis of Pneumocystis carinii pneumonia, bacterial pn eumonia and miliary tuberculosis in HIV positive patients.