Disseminated pulmonary infection due to Cryptococcus neoformans in a non immunocompromised patient

We report a case of a primary pulmonary infection due to Cryptococcus neoformans developed in a 40 year old immunocompetent and HIV negative man. Rodiologic findings consisted in diffuse, bilateral reticular and nodular opacities. Bronchoscopy was normal and bronchoalveolor lavage showed numerous macrophages without associated pothogens. A thorocovideoscopy with an open lung biopsy showed numerous cryptococci, free in the alveoli or located within the mocrophages. They were associated with an inflammatory infiltrate in the interalveolar spaces, predominantly composed of mononuclear cells. Ultra-structural study showed yeasts with numerous intracytoplasmic organites, a nucleus, a wall and a thick capsule. Pulmonary cryptococcosis is rare in immunocompetent hosts and can be difficult to diagnose since clinicoradiologic features observed in this cryptococcol infection mimic other infectious or neoplastic diseases.