Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Spontaneous pneumothorax from cryptococcal pneumonia in systemic sclerosis: a case report. | Sripavatakul and Foocharoen Journal of Medical Case Reports 2011 5 309 http content 5 1 309 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Spontaneous pneumothorax from cryptococcal pneumonia in systemic sclerosis a case report Kwanreuthai Sripavatakul and Chingching Foocharoen Abstract Introduction Spontaneous pneumothorax is usually found in people with systemic sclerosis who have extensive pulmonary fibrosis with enlarged sub-pleural blebs. We report a case of spontaneous pneumothorax caused by cryptococcal pneumonia in a patient with systemic sclerosis with minimal sub-pleural emphysema. Case presentation A 49-year-old Thai man with underlying limited cutaneous systemic sclerosis presented with acute low-grade fever progressive dyspnea and right pleuritic chest pain for five days. Our patient had pulmonary fibrosis with bronchiectasis of both lower lungs related to this underlying disease. He received only low-dose steroid therapy without any immunosuppressant. A chest radiograph revealed right lung pneumothorax with cloudy yellow color pleural fluid. Cryptococcal pneumonia was diagnosed by positive identification of the cryptococcal antigen in the serum and pleural fluid. His symptoms improved after intercostal drainage and fluconazole therapy. Conclusion Infection can exacerbate symptoms in patients with systemic sclerosis with sub-pleural emphysema thereby triggering a spontaneous pneumothorax. Pleural fluid-present but not initially seen because of the pneumothorax-could be a clue to a pre-existing pulmonary infection. Introduction Systemic sclerosis SSC is a rare systemic disease with the classic clinical characteristic of skin tightness. The disease is classified into two major types limited cutaneous SSC lcSSC and diffuse cutaneous SSC dcSSC . In lcSSC the skin on the face neck and below the elbows and knees thickens while in dcSSC the thickening extends to the trunk arms and thighs. Internal organ involvement .
