# Pulmonary cryptococcosis with headache as the first presentation: A case report

## TL;DR

A case report highlights a rare instance where a lung fungal infection first showed as a headache and was initially mistaken for cancer.

## Contribution

The paper presents a unique clinical case of pulmonary cryptococcosis misdiagnosed as lung cancer with brain metastasis.

## Key findings

- The patient's symptoms and imaging suggested lung cancer, but a biopsy confirmed pulmonary cryptococcosis.
- Prompt antifungal treatment after accurate diagnosis led to a positive patient outcome.
- The case emphasizes the need to consider fungal infections in differential diagnoses to avoid misdiagnosis.

## Abstract

Pulmonary cryptococcosis (PC) is an invasive fungal infection caused by Cryptococcus neoformans or Cryptococcus gattii. Its clinical presentation and radiological findings are often non-specific, making early diagnosis challenging. Herein, the case of a 44-year-old male who presented with dizziness and headache is reported. Initial cranial magnetic resonance imaging and chest computed tomography (plain and contrast-enhanced) suggested lung cancer with brain metastasis. A definitive diagnosis was established only after a lung mass biopsy, followed by a cytological smear and histopathological analysis, confirmed PC. The patient was treated with antifungal therapy postoperatively and responded well. This case underscores the importance of considering PC in differential diagnoses to enable prompt diagnosis and treatment, potentially reducing associated mortality.