Pulmonary Cryptococcosis Presenting as Pneumothorax in a Patient with AIDS

Cryptococcus neoformans is a common fungal pathogen in humans and is a significant opportunistic pathogen in patients infected with HIV-1. Cryptococcal infections may involve any organ, but the predominant sites are the lung and CNS. Pulmonary cryptococcosis may be asymptomatic or symptomatic and may occur with or without evidence of disseminated disease. The radiographic appearance of cryptococcal pulmonary disease includes solitary subpleural nodules, hilar and mediastinal adenopathy, pleural effusions, and, rarely, cavitation. We describe herein an HIV-1-infected patient who presented with pneumothorax as the initial manifestation of pulmonary cryptococcosis, and we review the English-language literature. Recognition of this clinical entity may contribute to earlier diagnosis and treatment of HIV-infected patients.