He Q, et al. - Researchers performed a comparison of the clinical features of pulmonary cryptococcosis patients with or without decreased peripheral blood CD4+ T cell counts to better understand pulmonary cryptococcosis. Findings revealed a significant impact of CD4+ T lymphocytes on the clinical and radiological characteristics of pulmonary cryptococcosis. They noticed less fever and more nodule-like radiographic findings among patients with normal CD4+ T cell counts.

Methods

• Researchers performed a retrospective review of the medical records of 80 patients with cryptococcosis who had been treated in Jingling Hospital from January 2011 to January 2016.
• In this population, researchers chose CD4 = 378/μL as a cut-off value in accordance to the normal range of peripheral blood CD4 + T-lymphocyte counts.

Results

• The patients with decreased CD4+ T cells, compared to the patients with a normal amount of CD4+ T cells, in higher proportion indicated fever (86.7% vs 28.6%, P < 0.001).
• No difference between patients with low CD4+ T cell counts and those with normal CD4+ T cell counts was noticed with respect to the incidence of clinical symptoms, such as cough (60.6% vs 64.7%, P=0.729), chest pain (9.1% vs 26.5%, P=0.064), and dyspnea (27.3% vs 23.5%, P=0.725).
• Higher number of asymptomatic patients were observed in the CD4+ T cell normal group than that in the decreased CD4+ T cell group (17.1% vs 0%, P=0.005).
• The CD4+ T cell normal patients had more common occurrence of nodules, masses, and halo signs than those with the low-CD4+ T cell patients (79.4% vs 54.5%, P=0.03).
• For cavitations, they noticed an opposite trend (14.7% vs 51.5%, P=0.001).
• The two groups did not significantly differ in terms of other CT findings, including pulmonary consolidation (P=0.205), and pleural effusion (P=0.641).