Clinical Analysis Of Pulmonary Cryptococcosis In Hiv-negative Hosts In China Mainland

Objective:Summarise the epidemiology, clinical manifestations,imaging finds and treatment methods of Pulmonary Cryptococcosos in HIV-Negative Hosts in China mainland in the recent fifiten years in order to improve the the level of clinal doctors’ diagnosis and treatment.Method:To search the relevant literature,through CNKI and WANFANG DATA according to the inclusion criteria and exclusion criteria and extract the available data.Statistical analysis was conducted using SPSS for windows(version 17.0).Results:122 literatures and 788 cases are collecte into my research.1、Basic information1 Regional distribution : In china,guangdong, zhejiang,Shanghai,has the most cases of PC, and the northeast and northwest has the least cases. In all,the southern region has 614 cases(77.9%) and the north region has 174 cases(22.1%).2gender: 527 cases(66.9%) are men and 261 cases(33.1%) are women. The sex ratio has no statistical difference between the north and south(X2 = 1.808, P = 1.808).3age: The patients’ age ranges from 20 months to 80 years old.Among them 72 cases are adults with the average age 46,, the average age was 46,16cases(2.0%) are juveniles with the age from 20 months to 14 years old.2、Risk factors: 1contact history: In this study,only 45cases(5.7%)have clear contact factor,including 29 cases once contacting with birds or poultry.Other possible contact factors are growing mushroomsworking in a pharmacy or antique shop、having a sauna often and so on. 2host factor: 545 cases(69.2%) are healthy and 243 cases(30.8%) have a history of disase. The healthy ratio has no statistical difference between the north and south(X2 =0.386,P=0.534).3、clinical manifestation:Clinical manifestations of HIV-negative patients with pulmonary cryptococcosis lack of specificity. And a small number of patients have no obvious symptoms, they are diagnosed through medical examination. In this study 130 cases(16.5%) have no symptoms.4 、 CT imaging: In this study 494 cases(62.7%)show masses/nodules shadow,116 cases(14.7%) show single or multiple patch shadow,178 cases(22.6%) shows other imagings. The constitute ratio of masses/nodules shadow、patch shadow and other imagings have no statistical difference between south and north(X2 = 0.113, P = 0.573).5 、 Diagnosis: In the study 312 patients(39.6%) were Diagnosed by surgery, 241 patients(30.6%) were diagnosed bypercutaneous lung puncture, 145 cases(18.4%) were diagnosedby TBLB, 41 cases(5.2%)were diagnosed by respiratory specimen(sputum or alveolar lavage)smear or culture, 15 cases(1.9%) were dignosed by Latex agglutination text,14 cases(5.2%) were diagnosed by the lymph node biopsies, 12cases(1.5%) were diagnosed by the cerebrospinal fluid smear or culture,3 cases(0.4%) were diagnosed by biopsy material smear or cultivate.2cases(0.3%) were diagnosed by skin biopsy combined with pulmonary symptoms, imaging findings, 2 cases(0.3%)were diagnosed by blood smear or cultivate, 1 case(0.1%) was diagnosed by autopsy. 6 、 Treatment: including antifungal drug therapy and surgery.Choose different treatments according to different situations.Conclusion :1 、 The regional distribution of pulmonary cryptococcosis has differences, occur more commonly in the warm and humid southern areas.2、The ratio of sex、host state and CT imaging have no statistical difference between south and north.3、The immunocompetent hosts without obvious contact factors can also suffer from the disease.4、The sensitivity of latex agglutination test is high, so it can be used to be as a preliminary check of pulmonary cryptococcosis, and to evaluate the patients’ outcome.Besides serum, alveolar lavage fluid, urine,cerebrospinal fluid and local tissue can be used to do the text.