Endobronchial cryptococcosis

Pulmonary cryptococcosis presents with a variety of clinical symptoms and radiographic abnormalities. It occurs in immunocompromised and immunocompetent individuals. Endobronchial involvement is rare and most commonly manifests as an endobronchial mass lesion. It can also present as localized plaques and pseudomembranous tracheobronchitis. We report the case of an immunocompromised patient with pseudomembranous tracheobronchitis secondary to endobronchial cryptococcal infection. Review of the literature revealed 7 additional cases with endobronchial involvement. Systemic disease and central nervous system involvement are frequently associated. Therefore, patients with endobronchial cryptococcosis should be evaluated by lumbar puncture and aggressively treated with either amphotericin B or fluconazole.