Cryptococcosis in an Immunocompetent Adolescent: A Case Report

Abstract

A 16-year-old male patient was admitted to our hospital with a diagnosis of “community-acquired pneumonia” following a two-week history of recurrent cough and productive expectoration that had failed to respond to prior outpatient anti-infective therapy. Despite initial empirical antibiotic treatment, his symptoms persisted. Chest computed tomography revealed a patchy consolidation in the left upper lobe, accompanied by an “air bronchogram” sign, which raised suspicion of an atypical pulmonary infection. To clarify the etiological diagnosis, bronchoalveolar lavage was performed, and the collected fluid was subjected to pathogen-targeted high-throughput gene sequencing. The results identified a Cryptococcus neoformans infection, confirming the diagnosis of pulmonary cryptococcosis. The patient was subsequently treated with oral fluconazole at a dosage of 300 mg/day for 9 days during hospitalization, leading to significant symptomatic improvement. He was discharged in stable condition and continued oral fluconazole as an outpatient. A 6-month telephone follow-up revealed that the patient remained asymptomatic with no evidence of disease recurrence, indicating a favorable clinical outcome.