Invasive Pulmonary Cryptococcal Infection Masquerading as Lung Cancer With Brain Metastases: A Case Report

Abstract Background: Cryptococcosis is a global disease problem. Although seen more frequently in the severely immuno-suppressed, it can also be seen in patients without apparent immuno-suppression. Patients with pulmonary Cryptococcosis typically present with cryptococcal pneumonia while brain cryptococcosis present with meningitis. Case presentation: Here we present our experience in the management of a 33-year-old immunocompetent man, diagnosed of invasive pulmonary Cryptococcal disease with spread to the brain. This case is unique because the patient was previously treated for tuberculosis and presented with typical bronchopulmonary (difficulty in breathing and cough), thoracic (diminished breath sounds and dull percussion notes), extra-thoracic (intra-cranial space occupying lesion) as well as Computed Tommography (CT) Scan features attributable to lung cancer. Diagnosis of Cryptococcosis was made by identification of oval thick-walled yeast on histology of lung biopsy specimen. Conclusions: We conclude that invasive Cryptococcosis affecting the lung and brain may present with a clinical picture similar to metastatic lung cancer. We recommend routine fungal stains and fungal culture in suspected cases.