{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T15:15:48Z","timestamp":1776870948889,"version":"3.51.2"},"reference-count":12,"publisher":"Microbiology Society","issue":"4","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Medical and Health Science Program of Zhejiang Province\uff08CN\uff09","award":["2025HY1530"],"award-info":[{"award-number":["2025HY1530"]}]},{"name":"The Medical and Health Science Program of Zhejiang Province\uff08CN\uff09","award":["2024KY572"],"award-info":[{"award-number":["2024KY572"]}]},{"name":"The Lishui Public Welfare Technology Application Research Program\uff08CN\uff09","award":["2022GYX26"],"award-info":[{"award-number":["2022GYX26"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,22]]},"abstract":"\n Introduction.<\/jats:bold>\n Pulmonary cryptococcosis is increasingly identified in routine care, including among patients with no recorded immunocompromising conditions.\n <\/jats:p>\n \n Hypothesis\/Gap Statement.<\/jats:bold>\n Real-world descriptions of pulmonary cryptococcosis are difficult to interpret because diagnostic intensity and case definitions vary across studies, and many cohorts reflect pathway-based rather than population-based case capture.\n <\/jats:p>\n \n Aim.<\/jats:bold>\n This study aimed to describe the clinical presentation, including asymptomatic\/incidental cases, and chest computed tomography (CT) patterns of pulmonary cryptococcosis by two-level immune status, and to report prespecified diagnostic evidence tiers (confirmed vs presumed).\n <\/jats:p>\n \n Methodology.<\/jats:bold>\n We conducted a single-centre, retrospective, observational study at a tertiary hospital in China (January 2016 to December 2020). The analytic cohort comprised adjudicated pulmonary cryptococcosis cases identified along a routine-care diagnostic pathway among patients with pulmonary imaging abnormalities who underwent serum cryptococcal antigen testing as part of clinical evaluation. Cases were classified using a prespecified two-tier evidence scheme (confirmed vs presumed).\n <\/jats:p>\n \n Results.<\/jats:bold>\n Among 62\u2009cases, 23\/62 (37.1%) were immunocompromised, and 39\/62 (62.9%) had no recorded immunocompromising conditions. Evidence tiers comprised 32\/62 (51.6%) confirmed and 30\/62 (48.4%) presumed cases. Cryptococcal meningitis was documented in 11\/62 (17.7%). Asymptomatic\/incidental presentation was recorded in 16\/62 (25.8%), including 4\/23 (17.4%) immunocompromised cases and 12\/39 (30.8%) cases with no recorded immunocompromising conditions. On chest CT, nodules\/masses were the most frequently recorded pattern in both groups, observed in 17\/23 (73.9%) and 31\/39 (79.5%) cases, respectively. Opacities\/consolidation, cavitation and loculated pleural effusion were recorded less often.\n <\/jats:p>\n \n Conclusion.<\/jats:bold>\n In this routine-care diagnostic-pathway cohort, nodules\/masses were the most frequently recorded CT pattern, and asymptomatic\/incidental presentation was documented in a substantial proportion of cases, including among patients with no recorded immunocompromising conditions. Separate reporting of confirmed and presumed cases may improve interpretation of cohorts assembled under non-uniform diagnostic work-up.\n <\/jats:p>","DOI":"10.1099\/jmm.0.002159","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:17:28Z","timestamp":1776867448000},"source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary cryptococcosis in routine care: the clinical\u2013radiologic spectrum and transparent evidence-tier reporting (confirmed versus presumed) among patients with no recorded immunocompromising conditions"],"prefix":"10.1099","volume":"75","author":[{"given":"Xiao-yao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Lishui Municipal Central Hospital (Lishui Hospital Zhejiang University), Lishui, Zhejiang, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Lishui Municipal Central Hospital (Lishui Hospital Zhejiang University), Lishui, Zhejiang, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-hong","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Lishui Municipal Central Hospital (Lishui Hospital Zhejiang University), Lishui, Zhejiang, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing-ping","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Lishui Municipal Central Hospital (Lishui Hospital Zhejiang University), Lishui, Zhejiang, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-bo","family":"You","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Lishui Municipal Central Hospital (Lishui Hospital Zhejiang University), Lishui, Zhejiang, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6005-0374","authenticated-orcid":false,"given":"Jian-min","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Lishui Municipal Central Hospital (Lishui Hospital Zhejiang University), Lishui, Zhejiang, PR China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"345","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myy086"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.129.2.333"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2361040460"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.1086\/649858"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ314"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2023.1291974"},{"key":"R7","doi-asserted-by":"publisher","DOI":"10.21037\/apm-21-127"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-020-4818-1"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.00345-22"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-024-03259-4"},{"key":"R11","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-020-01351-2"},{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1186\/s13244-024-01871-w"}],"container-title":["Journal of Medical Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/jmm\/10.1099\/jmm.0.002159?crawler=true&mimetype=application\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T14:17:28Z","timestamp":1776867448000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.microbiologyresearch.org\/content\/journal\/jmm\/10.1099\/jmm.0.002159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,22]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4,22]]}},"URL":"https:\/\/doi.org\/10.1099\/jmm.0.002159","relation":{},"ISSN":["0022-2615","1473-5644"],"issn-type":[{"value":"0022-2615","type":"print"},{"value":"1473-5644","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,22]]}}}