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Table 1 Summary of pleural effusion (PE) tested with CrAg in PC cases in the literature

From: Pleural fluid secondary to pulmonary cryptococcal infection: a case report and review of the literature

Year Author Age/gender Localized or Disseminated Predisposing Conditions Lympopenia Culture for Cryptococcus neoformans CrAg Pulmonary Lesions Treatment Out-come
PE BAL Serum CSF Sputum PE Serum CSF
1978 Gross 66/M Disseminated Steroids Yes + NR NR NR + Left side PE and LLL infiltrate Amphotercin B; 5-fluorocytosine; transfer factor; surgery CR
1980 Young case 1 42/M Localized Diabetes mellitus, Chronic renal failure NR + NR NR + Right side PE Amphotercin B; 5-fluorocytosine CR
  case2 66/F Localized Accurate renal failure NR + NR + NR + + + Bilateral PE Amphotercin B CR
1990 Conces 53/F Disseminated Renal transplant NR + NR NR NR + NR Right side PE Amphotercin B; NR
1998 Fukuchi 52/F Localized Chronic renal failure; Rheumatoid arthritis; Steroids No + NR NR NR + + Left side PE and LLL infiltrate Amphotercin B; 5-fluorocytosine; Fluconazole CR/PR
1999 Wong 30/F Disseminated None NR NR + NR + NR + Bilateral PE; LLL cavitating infiltrate Amphotercin B; 5-fluorocytosine; Fluconazole CR
2007 Jain et al. 50/M Localized HIV-positive Yes + NR NR NR NR + NR NR Left side PE Fluconazole CR
2008 Kamiya et al. 83/M Disseminated Myelodysplastic syndrome Yes NR + NR + + + Bilateral PE and RLL infiltrate Fosfluconazole; Lyposomal-amphotercin B PR/Dieda
2009 Kamminga et al. 47/F Disseminated Thymoma undering chemotherapy NR + NR + Right side PE; Thymoma in the left hemithorax Amphotercin B; 5-fluorocytosine; Fluconazole CR
2012 Present case 77/M Localized NSCLC Stage IIIB with Radio-chemotherapy; COPD Yes + ND + Left side PE and LLL infiltrate Fluconazole, oral 400 mg/d CR
2015   63/M Localized renal transplant recipient on an immunosuppressive regimen No NR ND + ND NR ND ND ND Left-sided pleural effusion with compressive atelectasis of LLL amphotericin B liposome combined with 5-flucytosine and voriconazole for first 11 days, then amphotericin B liposome combined with 5-flucytosine sustained to 8 weeks, after that changed to fluconazole for maintenance PR
2018 Kushima et al. 80/M Localized Steroids treatment due to rheumatoid arthritis, then developed pulmonary tuberculosis and cryptococcal pleuritis No + NR NR NR NR ND + ND Bilateral PE and Consolidation in LUL and a nodule in the LLL Anti-tuberculosis and anti-fungal agents PR/Dieda
  1. NR Not recorded, CR Cured/complete Response, PR Partial Response
  2. aCryptococcus neoformans disappeared from the right pleural effusion, and his condition improved temporarily by continuing fosfluconazole after discontinuing L-AMB because of renal dysfunction. However, the patient gradually became malnourished, and died of respiratory failure after a complication of aspiration and renal failure regardless of antibiotic therapy