Pulmonary Cryptococcosis Infection in Non‐HIV Patients in a Tertiary Care Center in Taiwan

BACKGROUND: Pulmonary cryptococcosis is an important opportunistic fungal infection in immunocompromised individuals, including those with an infection of the human immunodeficiency virus (HIV) but it can be increasingly seen in non-HIV patients. METHODS: We retrospectively reviewed the medical records of 58 non-HIV-infected patients with International Classification of Diseases, Ninth Revision, Clinical Modification Code B45.0 (pulmonary cryptococcosis) who were admitted to the Chi-Mei Hospital, Taiwan from January 2016 to April 2022. RESULTS: Of the enrolled 58 cases, 56 patients had no evidence of disease outside the lungs, and only two patients (3.4%) had disseminated diseases. Thirty-nine patients had pathologically confirmed pulmonary cryptococcosis, and 19 patients had clinically confirmed disease. Pulmonary cryptococcus patients with cancer had a nonsignificant numerically higher rate of ICU use (14.29% vs. 5.13%; p = 0.348). There were similar mortality rates in both cancer and noncancer patients with pulmonary cryptococcosis (4.76% vs. 2.70%; p = 0.581). Patients in the cancer and noncancer groups had a similar duration of hospital stay (7 vs. 6 days, p = 0.799) and low mortality rates (4.76% vs. 2.70%, p = 0.581) on standard antifungal therapy. CONCLUSIONS: Cancer and noncancer patients had similar good outcomes after receiving appropriate standard antifungal treatment. Asymptomatic patients with pulmonary cryptococcosis diagnosed incidentally are self-limited and require no antifungal therapy. TRIAL REGISTRATION: IRB number: 11111-004.