Meta-Analysis of Clinical Manifestations of Pulmonary Cryptococcosis in China Mainland

Objective:To investigate the clinical characteristics of pulmonary cryptococcosis(PC) in recent years in China mainland,which can be used as the scientific reference for the diagnosis and treatment of PC.Methods:CNKI website China Knowledge Resource Integrated Database have been digged into to collect the case reports of PC from the domestic statistical source journals from Jan 1981 to Dec 2008 to carry out Meta-analysis.Results:(1)A total of 113 reports have been selected and 728 patients with PC were reported.There were 505 males and 223 females.(2) 86.4 %(506/585) patients had no contact history of bird droppings and soil etc.(3)69.7 %(404/580) patients had no underlying diseases.The common underlying diseases were acquired immune deficiency syndrome(AIDS),diabetes,malignant tumor etc.71.5 %(434/607) patients went to hospital because of cough,expectoration,fever,chest pain etc.Few patients had physical abnormity.(4)The regular laboratory examinations have no specificity.(5)As to the thoracic radiological manifestation,71.8 %(155/216) patients were characterized by nodular lump shadows;20.8 %(45/216) by flake-like infiltrated shadows,and 7.4 %(16/216) had diffuse mixed lesions.Nodular lump shadows mostly occured in the patients without underlying diseases,while diffuse mixed lesions mostly occured in the patients with underlying diseases.(6)84.3 %(166/197) patients′ pathological finding was granulation tumor.(7)56.7 %(310/547) patients got their definite diagnosis by pathological test after the operation.The other ways to make the definite diagnosis were the pathological test results of the percutaneous needle lung biopsy,electron tracheoscope-guided transbronchial lung biopsy and lymph node puncture,the culture results of samples from respiratory tract or other humor etc.Conclusions: In China mainland,most patients with PC have no underlying diseases.The typical clinical manifestations are the symptoms and signs of respiratory system infection,some of the patients have no symptoms.The thoracic radiological manifestations have certain specificity,which has suggestive meanings to the diagnosis.Operative biopsy,percutaneous needle lung biopsy,electron tracheoscope-guided transbronchial lung biopsy have significant meanings to the diagnosis of PC.