Skip Navigation LinksHome > August 2010 - Volume 340 - Issue 2 > Life-Threatening Asymptomatic Incidentaloma: A Case Report o...
American Journal of the Medical Sciences:
doi: 10.1097/MAJ.0b013e3181e5f118
Case Report

Life-Threatening Asymptomatic Incidentaloma: A Case Report of Idiopathic CD4 Lymphocytopenia and Opportunistic Infections.

Tsalik, Ephraim L. MD, PhD; Jaggers, Lauren Brett MD

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Abstract

Incidental lung nodules can be due to a variety of etiologies. Management is guided by the most likely or urgent pathology, which is frequently malignancy in an elderly smoker. We present the case of a 62-year-old, long-time smoker, with an incidental lung nodule. Pursuit of the underlying etiology revealed disseminated cryptococcal and Mycobacterium avium intracellulare infections, which are most often seen in patients with advanced human immunodeficiency virus-acquired immunodeficiency syndrome or other immunocompromise. This patient was ultimately determined to have idiopathic CD4 lymphocytopenia, a rare and poorly understood acquired immunodeficiency syndrome. Furthermore, Cryptococcus neoformans is well known to cause asymptomatic meningitis in immunocompetent individuals but is very rarely asymptomatic in the immunosuppressed, as was the case with this patient.

© Copyright 2010 Southern Society for Clinical Investigation

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