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Lung India Official publication of Indian Chest Society  
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Year : 2008  |  Volume : 25  |  Issue : 4  |  Page : 155-157

Endogenous excess cortisol production and diabetes mellitus as predisposing factors for pulmonary cryptococcosis: A case report and literature review

Department of Pulmonary Medicine and Pathology, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
B Thangakunam
Dept. of Pulmonary Medicine, Christian Medical College, Vellore 632004, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-2113.45281

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Pulmonary cryptococcosis usually occurs as an opportunistic infection in immuno­compromised patients. Endogenous Cushing's syndrome is associated with cortisol excess and can predispose to development of cryptococcal infections. We report a case of diabetic patient with ACTH secreting pituitary tumour who developed a cavitating lung mass. Computed tomography-guided biopsy of the lesion revealed mucicarminophilic budding forms of cryptococcus. Broncheoalveolar lavage culture grew Cryptococcus neoformans. There was radiological response to treatment with liposomal Amphotericin, but patient ultimately succumbed to septicemia and multiorgan failure. Opportunistic infections with organisms like Cryptococcus neoformans, should be considered in patients with en­dogenous Cushing's syndrome and a pulmonary infiltrate.

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