CTICasesCryptococcus gattii
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Imaging findings
A 42-year-old woman with night sweats and headaches presented with multiple lung lesions, including a large anterior right lesion with chest wall involvement, an inhomogeneous lesion at the left base, and another lesion behind the heart. These lesions were inhomogeneous with contrast.
Key takeaways
A needle biopsy of the right lung lesion revealed Cryptococcus, presumed to be gattii due to its prevalence in the Pacific Northwest (Whistler/Vancouver travel history) and the patient's lack of immune compromise. Cryptococcus gattii is often more aggressive and does not require a compromised host like C. neoformans. Headaches raised suspicion for brain involvement, common with Cryptococcus. The geographic spread of C. gattii to areas like the Eastern US, Georgia, and Michigan, along with different genotypes, suggests complex environmental and transmission dynamics.
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