Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5510
Peer-review started: January 21, 2022
First decision: March 23, 2022
Revised: March 30, 2022
Accepted: April 30, 2022
Article in press: April 30, 2022
Published online: June 6, 2022
Processing time: 131 Days and 22.9 Hours
Pleural involvement of cryptococcal infection is uncommon and is more commonly observed in immunocompromised hosts than in immunocompetent ones. Pleural involvement in cryptococcal infections can manifest with or without pleural effusion. The presence of Cryptococcus spp. in the effusion or pleura is required for the diagnosis of cryptococcal pleural infection, which is commonly determined by pleural biopsy, fluid culture, and/or detection of cryptococcal antigen in the pleura or pleural fluid.
Core Tip: The importance of pleural involvement in cryptococcal infections is often overlooked. When biopsy results are inconclusive, further testing for invasive granulomatous infections, such as pulmonary cryptococcosis, should be done. When indicated, a sensitive cryptococcal antigen assay and fungal culture should be used to evaluate pleural effusion specimens. Even if the cryptococcal antigen test is negative, clinicians should investigate pleural cryptococcosis in cases of pleural nodules without pleural effusion, especially in the context of immunosuppression.