{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:43:39Z","timestamp":1781624619680,"version":"3.54.5"},"reference-count":17,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,16]],"date-time":"2024-02-16T00:00:00Z","timestamp":1708041600000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Isolated cryptococcal pleural effusion is rare as the initial clinical presentation in opportunistic cryptococcal infection. We describe a 59\u2010year\u2010old male heart transplantation recipient who presented with a mononuclear\u2010leukocyte\u2010predominant exudative pleural effusion, with adenosine deaminase levels (ADA) of 37\u2009IU\/L and focal pleural nodularity on computed tomography. A thorough evaluation, including pleural fluid culture, cryptococcal antigen, and histological examination, led to the diagnosis of cryptococcal pleural effusion. Antifungal therapy with fluconazole of 400\u2009mg\/day showed clinical and radiological improvement. A literature review identified six cases of cryptococcal pleural effusion that reported pleural fluid ADA levels. All cases, including the present one, involved immunocompromised hosts and exhibited a mononuclear\u2010leukocyte\u2010predominant exudate. High pleural fluid ADA levels were observed in approximately half of these cases. The pleural fluid cryptococcal antigen test was an important diagnostic tool for early diagnosis. In an era where immunocompromised hosts are increasing, cryptococcal infection should be considered as a potential aetiology in immunosuppressed patients with an exudative pleural effusion of unknown cause, even if ADA levels are elevated.<\/jats:p>","DOI":"10.1002\/rcr2.1297","type":"journal-article","created":{"date-parts":[[2024,2,17]],"date-time":"2024-02-17T00:58:50Z","timestamp":1708131530000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Isolated cryptococcal pleural effusion in a heart transplant recipient: A case report and literature review of pleural fluid adenosine deaminase levels"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8111-7320","authenticated-orcid":false,"given":"Jaehee","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Kyungpook National University, School of Medicine  Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo Eun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kyungpook National University, School of Medicine  Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se Yong","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kyungpook National University, School of Medicine  Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1550-5752","authenticated-orcid":false,"given":"Chang Ho","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Kyungpook National University, School of Medicine  Daegu Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000016354"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1132-4"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.37.534"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.5414\/CNP72229"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000216831"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/rcr2.294"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.9020-17"},{"issue":"4","key":"e_1_2_8_9_1","first-page":"743","article-title":"Pleural effusions due to Cryptococcus neoformans: a review of the literature and report of two cases with cryptococcal antigen determinations","volume":"121","author":"Young EJ","year":"1980","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2018-224786"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-019-4343-2"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v8.i7.1295"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.06-2063"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2007.12.007"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v10.i16.5510"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2017.02.013"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2023.04.021"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13543"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.1297","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T01:12:41Z","timestamp":1708909961000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.1297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":17,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/rcr2.1297"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.1297","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]},"assertion":[{"value":"2023-10-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-06","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e01297"}}