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Figure 1. A 68-year-old man who had had biopsy-proved cryptococcal pneumonia 19 years earlier after cleaning a pigeon-infested barn was admitted to the hospital with increasing dyspnea, nonproductive cough, reduced exercise tolerance, and fever. His earlier episode of pneumonia had been treated with amphotericin B, but he was able to receive only a total of 1.5 g of the drug, because renal tubular acidosis, azotemia, and electrolyte disorders developed. He had been asymptomatic in the intervening years.
On admission, a chest radiograph showed five-lobe alveolar infiltrates (Panel A). Flexible fiberoptic bronchoscopy revealed cryptococci. Despite treatment with large doses of . . . [Full Text of this Article] |
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