Pulmonary cryptococcosis presenting as hemoptysis: A case report

This 28 year-old male suffered from chronic cough with hemoptysis for three months. Chest radiograph demonstrated a subpleural mass at left lower lobe. Fine needle aspiration cytology (FNAC) revealed a granulomatous lesion with refractile yeast forms of Cryptococcus, both within the multinuclcate giant cells and extracellularly. This was subsequently confirmed by histology. The presence of the serum cryptococcal antigen titer as high as 1:256X was also noted. Treatment with fluconazole 400mg was administered. The serum cryptococcal antigen titer was 1:64 two months after treatment. The cryptococcal antigen titer decreased with the improvement of clinical signs and the resolution of chest X-ray abnormalities, and there was no relapse of hemoptysis.