%0 Journal Article %T Criptococosis Pulmonar Primaria en Paciente con SIDA %A Beatriz Torres Exp車sito %A Margarida Franˋa %J Medicrit : Revista de Medicina Cr赤tica %D 2009 %I %R 10.5413/mrmc.2009.61.114 %X Aunque el pulm車n es la puerta de entrada natural para el Cryptococcus, la criptococosis se suele manifiestar como meningitis. El derrame pleural aislado es raro y normalmente asociado con patologia parenquimatosa. Relatamos el caso de un paciente VIH1 positivo con toxoplasmosis cerebral y sarcoma de Kaposi no recientes. Sometido a estudio de derrame pleural, cuyo abordaje revel車 un exudado serohem芍tico con predominio de mononucleares. El TAC tor芍cico evidenci車 un derrame pleural con consolidaci車n adyacente. El examen cultural del liquido pleural fu谷 positivo para Cryptococcus neoformans. Sin evidencia de afectaci車n meningea y con antigeno para Cryptococcus en otros fluidos corporales negativo, se instituy車 terap谷utica con anfotericina lipos車mica seguida de fluconazol. Tras diez meses la imagen muestra regresi車n evidente del derrame. Ante un derrame pleural en un paciente HIV positivo, la posibilidad de una infecci車n primaria por Cryptococcus debe ser considerada. Palabras clave: Criptococosis; Derrame pleural; Cryptococcus neoformans; SIDA. ............... Primary Lung Cryptococcosis in Patient with AIDS ABSTRACT Although the lung is the natural entry to Cryptococcus, criptococcosis manifests most commonly as meningitis. Isolated pleural effusion is rare and usually associated with parenquimal disease. A right pleural effusion was found in a 62 years old man. HIV positive, with prior cerebral toxoplasmosis and Kaposi∩s sarcoma. The study revealed a serohematic exsudate with mononuclear cells predominance. Thoracic CT showed pleural effusion with adjacent consolidation. Cultural exam of the pleural fluid was positive for Cryptococcus neoformans. There was no evidence of meningeal involvement and detection of Cryptococcus antigen in corporal fluids was negative. Treatment with liposomal amphotericin was started followed by fluconazol. Subsequent cultural exams were sterile. After 10 months of treatment the imagiological control shows insignificant pleural effusion. When studying a pleural effusion in HIV patient, the possibility of primary criptococcosis infection must be considered. Key words: Criptococcosis; Pleural effusion; Cryptococcus neoformans; AIDS. %K criptococosis %K derrame pleural %K Cryptococcus neoformans %K SIDA %K pleural effusion %K AIDS %U http://www.medicrit.com/mrmc/index.php/mrmc/article/view/114