Dr. Manun revealed the case of an 84-year-old female patient who developed pneumonia caused by Cryptococcus fungal infection after regularly cleaning pigeon droppings on her balcony. Fortunately, the fungus did not spread beyond the lungs.
On 12 Jan 2026 GMT+7, Dr. Manun Lechwong, a respiratory specialist at Vichaiyut Hospital, posted a message on Facebook.Dr. Manun Lechwong FCHe stated that the patient, an 84-year-old Thai woman, was a nonsmoker with no cough, fever, fatigue, loss of appetite, weight loss, or headache. She was independent and had a history of hypertension, high cholesterol, and diabetes, and came for her annual physical examination.
Physical examination showed no fever, and lung auscultation was normal. Chest X-ray revealed abnormal shadows in the upper right lung due to previous tuberculosis and a new mass measuring 1.9 × 1.9 centimeters in the lower right lung. This mass was new, not present the previous year. CT scan of the lungs showed a mass measuring 3.0 × 2.4 × 2.0 centimeters in the lower right lung. Blood tests for tumor markers were all normal.
A needle biopsy of the mass was performed, and pathology revealed pneumonia caused by Cryptococcus fungus. Blood test for Cryptococcus antigen was positive with a titer of 1:20. Brain CT scan and cerebrospinal fluid examination were normal, showing no spread of Cryptococcus to the meninges.
Diagnosis: Pneumonia due to Cryptococcus fungal infection.
Treatment was started with the antifungal drug fluconazole, to be taken continuously for at least six months.
History revealed the patient lived in a four-story building on the second floor. The household had kept many pigeons on the rooftop for several years. Pigeons frequently perched on the balcony and window sill of the patient's room. The patient regularly cleaned pigeon droppings from the balcony and window sill.
This patient inhaled spores of the fungus Cryptococcus neoformans from pigeon droppings into her lungs, causing localized pneumonia characterized by a mass. Fortunately, the infection did not spread beyond the lungs because her immune system was still strong.
It is recommended that everyone keep a distance and avoid cleaning pigeon droppings. If cleaning is necessary, wear a face mask, preferably an N95, to prevent inhaling fungal spores into the lungs.