Purpose: To determine the incidence of acute respiratory failure (ARF) in n
on-AIDS patients with pulmonary cryptococcosis (PC).
Design: Retrospective cohort study.
Setting: University of Pittsburgh Medical Center, Pittsburgh, Ph.
Subjects: All patients in whom PC without HN infection was diagnosed betwee
n February 1989 and March 1999.
Results: Thirty-three patients with PC were identified, and 11 of those pat
ients (33%) developed ARF and comprised the study group. Underlying disease
s included solid-organ transplant recipients (seven patients; 64%) and othe
r underlying medical conditions (four patients; 36%), The most common sympt
oms were cough, shortness of breath, and temperature elevation. Extrapulmon
ary involvement was seen in six patients (meningitis, four patients; perito
nitis, one patient; laryngeal mass, one patient), Six of the 11 patients (5
5%) died.
Conclusion: ARF may develop in one third of non-AIDS patients with PC, This
clinical syndrome is associated with the dissemination to extrapulmonary s
ites and high mortality rates. PC should be recognized as a possible cause
of respiratory failure in non-AIDS patients.