Diagnosis and treatment of four cases of pulmonary cryptococcosis: case report and literature review.

Abstract

INTRODUCTION Cryptococcosis has attracted global attention due to its high mortality rate, unique geographical distribution, and tendency to cause severe and rapid disease progression. Metagenomic next-generation sequencing (mNGS) is a novel detection technology that provides diagnostic insights for identifying pathogens, particularly rare ones. The present article describes 4 individuals diagnosed with pulmonary cryptococcosis (PC) using mNGS of bronchoalveolar lavage fluid (BALF). CASE PRESENTATION Among these patients, 3 had cancer, 1 had sarcoidosis and diabetes, and 2 were exposed to pigeons and/or pigeon droppings. These patients experienced symptoms, including fever, cough, and chest pain. They were diagnosed with PC after mNGS of BALF. The patient was diagnosed based on mNGS test results. Subsequently, the patient was treated with fluconazole, and the patient's chest computed tomography scan showed significant absorption of the lung lesions. CONCLUSIONS mNGS of BALF can quickly diagnose PC. This diagnostic method has minimal trauma to the body and is worthy of clinical promotion. Fluconazole remains the preferred and best therapeutic drug for PC treatment.