CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1569949
Pulmonary cryptococcosis in the setting of immunosuppression by methylprednisolone monotherapy for Oral pemphigus: A case report and literature review
Provisionally accepted
Hongxia Mei1
Pengchen Bao2
Yongxu Wang1
Zhijing Wei1Qin Yang1Chen Chen1Yakai Sun1Xinming Su1
WenYang Li1*- 1Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
- 2China Medical University, Shenyang, Liaoning, China
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Cryptococcosis is an opportunistic and fatal fungal infectious disease. Pemphigus diseases are cutaneous and mucous membrane blistering diseases. We reported a case of Pulmonary cryptococcosis (PC) following methylprednisolone treatment for pemphigus vulgaris. We also analyzed a case series of PC infection recorded in PUBMED from 2013 to 2023. As a result, 229 cases of PC were enrolled. Median age was 54 years, with 66.4%male patients. Those with previous use of Corticosteroid or immunosuppressive accounted for 38.4%. Underlying diseases were solid organ transplantations (25.7%), respiratory diseases (6.6%), malignant tumors (6.1%), rheumatoid arthritis (5.7%), hematological malignancies (4.4%), et al. The main source of infection was exposure to birds, poultry and their feces (12.7%).Cryptococcus neoformans was most frequently isolated (76.4%). Overall mortality was 14.8%. Previous use of corticosteroids or immunosuppressive was a risk factor for disseminated cryptococcus (p<0.05). Age, underlying disease, dissemination, and no antifungal therapy independently associated with increased mortality (p<0.05). Co-promoting factor 删除[子 梅]: occurrence of pemphigus and PC is rare. Prompt diagnosis and appropriate treatment of PC are essential to prevent fatal consequences. Corticosteroids or immunosuppressive therapy associated with development of disseminated cryptococcal infection. Age, underlying disease, and dissemination related with increased mortality. Timely antifungal therapy can improve prognosis.
Keywords: Pulmonary cryptococcosis, Pemphigus Vulgaris, corticosteroids, antifungal therapy, Immunity
Received: 05 Feb 2025; Accepted: 02 Jun 2025.
Copyright: © 2025 Mei, Bao, Wang, Wei, Yang, Chen, Sun, Su and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: WenYang Li, Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
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