Table 4.
The patterns of treatment and outcome of pulmonary cryptococcosis.
| First-Line Treatment, n (%) | N = 321 |
|---|---|
| No treatment | 5 (1.6) |
| Surgical resection only | 34 (10.6) |
| Antifungal treatment | 282 (87.9) |
| Fluconazole * | 251 (89.0) |
| Amphotericin-B-containing regimen # | 31 (11.0) |
| Second-line treatment, n (%) | N = 25 |
| Reasons for second-line treatment | |
| Disease stasis or progression | 21 (84.0) |
| Intolerance of first-line treatment | 2 (8.0) |
| Exclusion of malignancy | 2 (8.0) |
| Types of treatment | |
| Surgical resection | 13 (52.0) |
| Amphotericin-B-containing regimen | 7 (28.0) |
| Add-on flucytosine | 3 (12.0) |
| Azoles other than fluconazole | 2 (8.0) |
| Outcome of first-line antifungal treatment $ | N = 218 |
| Complete response | 39 (17.9) |
| Part response | 136 (62.4) |
| Stable disease | 28 (12.8) |
| Disease progression | 15 (6.9) |
| Overall outcome | N = 321 |
| Complete treatment without recurrence | 256 (79.8) |
| Alive with disease recurrence | 4 (1.2) |
| Death | 41 (12.8) |
| Cryptococcosis related | 8 (2.5) |
| Not cryptococcosis related & | 33 (10.3) |
| Incomplete treatment and loss of follow-up | 20 (6.2) |
* Includes 28 patients who underwent surgical biopsy or resection before antifungal treatment. # Four patients did not undergo fluconazole maintenance because of early death; all of them had underlying autoimmune disease and 3 of them had fungemia. $ Excludes patients without treatment, with surgical resection, loss of follow-up, and not-cryptococcosis-related death before complete treatment. & Includes 2 patients with recurrent cryptococcosis.