Isolated Pleural Cryptococcosis in an Immunocompetent Patient-A Case Report

Pleural effusion is an unusual manifestation of cryptococcal infection, and when it does occur, it is almost always accompanied by pulmonary parenchymal disease, usually in the form of infiltrates or nodules. A subpleural nodule is often found immediately subjacent to the effusion, suggesting that the pathogenesis of such an effusion involves direct spread from the subpleural focus. Pleural effusion occasionally occurs in immunocompromised patients with cryptococcosis and suggested disseminated disease. In hosts with a normal immune status and cryptococcosis, pleural effusion is rarely seen. We report a case of isolated pleural involvement by cryptococcus in an immuncompetent patient. A 53-year-old male suffered from chest pain and dyspnea for 1 week. Chest X-ray on presentation showed left-side pleural effusion, and chest CT revealed a small amount of fluid in the left pleural space. There were no pulmonary parenchymal lesions. The pleural biopsy revealed cryptococcosis and chronic granulomatous inflammation.