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China - Woman diagnosed with cryptococcal pneumonia after contact with pigeons, Guangdong province - May 18, 2025

sharon sanders

Editor-in-Chief & President
After coughing for a week, a 30-year-old woman was diagnosed with a "hidden killer" with a mortality rate of up to 80%.
Qujing Pearl River Network2025-05-18 21:59


Recently, Ms. Xia (pseudonym), 30 years old, from Guangzhou
Went to hospital for a week-long dry cough
Chest CT showed multiple infections in both lungs
With multiple cavitation
Admitted to the Department of Respiratory and Critical Care Medicine


During the ward rounds, the doctor spotted a special image on the CT scan that looked like a "ghost face" (i.e., the "ghost face sign"), accompanied by a "dizziness sign," and highly suspected cryptococcal pneumonia.
The doctor asked Ms. Xia whether she had recently come into contact with birds, poultry, or kept pets, but she denied it.


The doctor arranged for Ms. Xia to have her blood drawn for cryptococcal antigen testing, and also arranged for a painless bronchoscopy, and sent her alveolar lavage fluid for cryptococcal antigen testing and tNGS (targeted high-throughput sequencing). The next day, both the blood and alveolar lavage fluid reported positive for cryptococcal antigen, and tNGS detected high-sequence new cryptococci. Ms. Xia was diagnosed with new cryptococcal pneumonia.



After learning about this diagnosis, Ms. Xia recalled that she received two pigeons from a friend two weeks ago. She kept the pigeons at home for four days and then slaughtered them to make soup. This was a clear history of contact. The doctor considered that the infection of Cryptococcus neoformans was related to the slaughter of pigeons. After standardized treatment, Ms. Xia recovered and was discharged from the hospital.

Meet the Master of Disguise Cryptococcal pneumonia
According to the doctor, Cryptococcus neoformans is a fungus that is widely found in pigeon droppings, soil and rotten plants. After drying, it forms aerosol particles that can infect the human body through inhalation of the respiratory tract.


High-risk groups include pigeon breeders, bird lovers, gardeners and others who have long-term contact with birds or soil, as well as those with weakened immunity (HIV, organ transplantation, long-term hormone use).


Doctors say that cryptococcal pneumonia may be asymptomatic in the early stages, and mild symptoms are similar to those of a cold (cough, low fever, chest pain), which can be easily ignored.

Severe cases may cause high fever, dyspnea, hemoptysis, etc. If cryptococcal pneumonia is not controlled in time, about 10% of patients will develop meningitis. The mortality rate of cryptococcal meningitis is as high as 60%-80%. If persistent headache, nausea and vomiting occur, you need to see a doctor immediately.


In terms of imaging manifestations, the typical CT manifestation is single/multiple nodules with "halo sign". Liquefaction and necrosis of nodules can form cavities resembling "ghost face sign". The cavities are often thin-walled and free of fluid.


Don’t panic! There is a treatment Follow doctor's orders for antifungal treatment
Doctors at the Panyu Central Hospital of Guangzhou Medical University remind that if you are infected with Cryptococcus neoformans, you should follow the doctor's advice to take antifungal treatment. You need to follow up closely at the outpatient clinic, take a full course of anti-infection treatment, and never stop taking the medicine on your own. Early diagnosis and early treatment are the key. Timely treatment can completely absorb the lesions in the lungs and avoid sequelae. In terms of prevention, please pay attention to:

Bird keepers:
Clean the bird cage daily (wear an N95 mask + rubber gloves). Place the bird cage in a ventilated place and avoid placing it in the bedroom. Wash hands thoroughly after contact and wash clothes in time.



High-risk activities:[
Avoid staying for a long time in places where pigeons gather, protect your mouth and nose when turning the soil for planting, and avoid contact with wild bird feces.


Health Monitoring:
If you experience persistent cough, chest pain, or fever, especially if you have a history of contact with birds, you should proactively inform your doctor to rule out cryptococcal infection.


Liu Zhitao, director of the respiratory and critical care medicine department of the hospital, reminded: In recent years, the incidence of cryptococcal pneumonia has increased three times! If the cough persists for more than 2 weeks and antibiotic treatment is ineffective, cryptococcal antigen screening must be performed. Early diagnosis can avoid fatal cryptococcal meningitis.


​zhttps://baijiahao.baidu.com/s?id=1832467026138813577&wfr=spider&for=pc
 
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