| Background:In recent years,pulmonary cryptococcosis(PC)the incidence rate is increasing,because of its clinical and imaging features of pulmonary are lack of specificity,invasive biopsy is not easy to be accepted,and the pathogenic detection rate is low,the diagnosis is difficult,Therefore,the use of cryptococcal antigen as an auxiliary means of immunological examination.However,most of the studies on cryptococcal antigen at home and abroad are focused on the latex agglutination test,and few studies on the clinical significance of colloidal gold in the diagnosis of pulmonary cryptococcosis.Objective:To study the sensitivity and specificity of colloidal gold in the diagnosis of PC,In order to evaluate the clinical significance of the diagnosis of pulmonary cryptococcosis in the absence of pathological support,at the same time,the clinical features of patients with PC were summarized,which can help clinicians to improve the understanding of PC and early diagnosis and treatment.Methods:All patients with suspected PC were collected from the second hospital of Jilin University from December 1,2014 to December 31,2016,and all patients were examined by colloidal gold method.Counting the sensitivity and specificity of colloidal gold,and The general data,clinical symptoms and signs,imaging findings,auxiliary examination,initial diagnosis and treatment of the patients with PC were analyzed retrospectively.Result:1.Result of Colloidal gold method :There were 131 cases of colloidal gold,of which there were positive in 19 cases and negative in 112 cases.Of the 19 cases,PC was positive in 13 patients,and the other was non PC in 6 patients;112 negative patients were non PC.The sensitivity of col-loidal gold method was 100%,specificity was 94.92%,positive predictive value was 68.42%,negative predictive value was 100%.2.Clinical features:13 cases of PC male and female ratio of 1.6:1,the majority of 50-60 years of age,and the contact history of Cryptococcus neoformans was denied.Only 1 cases had sewage contact history.No underlying disease accounted for 46.15%,and the basic disease accounted for 53.85%.The main performance is:(69.23%)cough and expectoration(46.15%),fever(23.08%),chest pain,shortness of breath(15.38%)(15.38%),hemoptysis(15.38%),night sweats(7.69%)and weight loss(7.69%),fatigue(7.69%)one or more symptoms of.The imaging findings of 6 cases were nodular / mass type(46.14%),2 cases were consolidation images(15.38%)and 5 cases were mixed type(38.47%).There were 3 cases with single lesion(23.07%),and there were 10 cases with multiple lesions(76.93%).The lesions were confined to one side of the lung in 8 cases(61.52%),and bilateral lung in 5 cases(38.48%).There were 11 cases(84.62%)in the vicinity of the lung and 2 cases in the central part of the lung(15.38%).With signs of vacuole sign(38.46%),halo sign(23.08%),air bronchogram(23.08%),burr(38.46%)(and),hilar or mediastinal lymph node enlargement(38.46%),pleural thickening(38.46%),leaf(7.69%),pleural effusion(7.69%),empty(15.38%).The early misdiagnosis rate was 69.23%.Following up ranged from 20 to 18 months,results 3 cases were lost to follow-up,and the other 1 cases were cured,and the other 6 cases were obviously improved,and the other 3 cases were improved.Conclusion:1?In this study,the sensitivity of colloidal gold method was 100%,specificity was 94.92%,positive predictive value was 68.42%,negative predictive value was 100%.And it is Stable at room temperature,simply operation,10 minutes can be the result,result determination is simple,Therefore,colloidal gold method has high value in the diagnosis and differential diagnosis of pulmonary cryptococcosis.In particular,it can be used as a screening method for cryptococcal infection,as well as a method for the diagnosis of cryptococcal infection.2?Pulmonary cryptococcosis is more common in immunocompromised patients and immunocompromised patients,But the proportion of patients with normal immune function is relatively high,can not be ignored.3?Patients with pulmonary cryptococcosis were more men than women.Good hair age is 50-60 years old.Most of the patients had no history of contact with poultry and poultry.clinical manifestations is short of specificity of clinical manifestations,cough is the most common,early misdiagnosis rate is high.The main imaging features of lung were three types of nodules / masses,solid and mixed type.Nodules / mass type,multiple lesions are common,mostly confined to the unilateral lung,the focus in the vicinity of the lung were common,can be accompanied by vacuole sign,burr,pleural thickening and other signs.4?The course of antifungal therapy for pulmonary cryptococcosis is longer,and there is no accurate antifungal therapy. |
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