Exacerbation of pulmonary cryptococcosis associated with enhancement of Th2 response in the postpartum period

Shota Miyoshi, Naohiro Oda, Yuka Gion, Takahiro Taki, Reo Mitani, Ichiro Takata, Akihiko Taniguchi, Yasuharu Sato, Nobuaki Miyahara

Research output: Contribution to journalArticlepeer-review

Abstract

Cryptococcosis is an invasive mycosis that has become increasingly prevalent in immunocompromised patients. Pregnant women are also one of the risk populations for cryptococcosis. Reversal of Th2 to Th1 response following resolution of immunosuppression during the postpartum period can lead to overt clinical manifestations of a previously silent infection, resembling an immune reconstitution inflammatory syndrome. Here, we report a case of a 30-year-old woman who had an exacerbation of pulmonary cryptococcosis in the postpartum period mimicking an immune reconstitution inflammatory syndrome. In the present case, chest computed tomography showed multiple small nodules on the day of the delivery; however, pulmonary cryptococcosis, which was subclinical during pregnancy, rapidly worsened to mass-like consolidation at one month after the delivery. Pathohistological examination of the lung specimen showed lung parenchyma infiltration with histiocytes and numerous lymphocytes without granulomatous formations, and a small number of yeast-like organisms consistent with Cryptococcus without capillary involvement. Immunohistochemical staining showed predominance of CD3+ cells and CD4+ cells over CD8+ cells. In addition, GATA3+ cells dominated over T-bet + cells. These data suggested exacerbation of pulmonary cryptococcosis associated with enhancement of Th2 response in the postpartum period.

Original languageEnglish
Pages (from-to)1248-1250
Number of pages3
JournalJournal of Infection and Chemotherapy
Volume27
Issue number8
DOIs
Publication statusPublished - Aug 2021

Keywords

  • Cryptococcosis
  • GATA3
  • Immune reconstitution inflammatory syndrome
  • Postpartum
  • Th2

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Pharmacology (medical)

Fingerprint

Dive into the research topics of 'Exacerbation of pulmonary cryptococcosis associated with enhancement of Th2 response in the postpartum period'. Together they form a unique fingerprint.

Cite this