Primary cutaneous cryptococcosis (original) (raw)
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A case of primary cutaneous cryptococcosis
European Journal of Clinical Microbiology & Infectious Diseases, 1997
The case of a 77-year-old man in whom a large digital ulcer with undermined edges was due to cutaneous infection by Cryptococcus neoformans variety neoformans serotype D, probably following direct inoculation, is reported. Long-term steroid treatment for chronic obstructive pulmonary disease may have been a risk factor. A 12-day course of intravenous amphotericin B at a cumulative dose of 750 mg, followed by oral fluconazole at a daily dose of 600 mg for six weeks, resulted in healing of the skin lesion. Manifestations of primary cutaneous cryptococcosis in immunocompetent or immunocompromised patients are reviewed.
Primary Cutaneous Cryptococcosis Caused by Cryptococcus neoformans in an Immunocompetent Patient
Journal of Clinical Medical Research, 2023
Background: Primary Cutaneous Cryptococcosis (PCC) is an uncommon disease restricted to cutaneous tissues caused by Cryptococcus spp. Case-report: We report a PCC case in a patient without any underlying disease. A 44-year-old man from Southern Brazil was referred to the hospital with 3-year recurrent skin lesions. A biopsy showed typical rounded and encapsulated blastoconidia typical of Cryptococcus and C. neoformans was identified in culture. Treatment with fluconazole (600 mg/day) was prescribed with improvement of the lesions. During the follow-up a self-reported interruption of treatment was detected and after 1 year of treatment, complete clinical cure was not yet achieved. Conclusion: This uncommon case reinforces the importance of mycologic examinations for correct diagnoses.
Postepy Dermatologii I Alergologii, 2020
Due to constantly growing population of immunocompromised patients the fungi became a widespread threat to modern medicine. HIV carriers, solid organ transplant recipients constitute most of those patients. Cryptococcosis is a frequent cause of life-threatening infections, affecting mostly immunosuppressed patients. This article presents current knowledge on cryptococcal infections, including epidemiology, clinical aspects, diagnosis and recommended treatment. In reference to our patient, who developed a disseminated and fulminant subtype of the disease, we wanted to underline the need to examine patients thoroughly. The highest aim of those measures would be to avoid lethal consequences.
Anais Brasileiros de Dermatologia, 2016
Cryptococcosis is a fungal infection caused by Cryptococcus neoformans that tends to affect immunocompromised individuals. The fungi are mostly acquired by inhalation, which leads to an initial pulmonary infection. Later, other organs-such as the central nervous system and the skin-can be affected by hematogenous spread. In addition, cutaneous contamination can occur by primary inoculation after injuries (primary cutaneous cryptococcosis), whose diagnosis is defined based on the absence of systemic involvement. The clinical presentation of cutaneous forms typically vary according to the infection mode. We report an unusual case of disseminated cryptococcosis in an immunocompetent patient with cutaneous lesions similar to those caused by primary inoculation. This clinical picture leads us to question the definition of primary cutaneous cryptococcosis established in the literature.
Systemic cryptococcosis in an immune-competent child
Journal of infection and public health, 2017
Crytococcus neoformans is an encapsulated yeast that frequently affects immune-compromised patients, although increasingly being detected in the immune-competent host as well. We report a case of disseminated cryptococcosis in a young child in whom no immune deficiency was yet identified. A 4-year-old child presented with high-grade fever, intermittent abdominal pain and generalized skin eruptions for the past two months. He had pallor, firm lymphadenopathy, skin lesions with scarring and firm hepatosplenomegaly. Magnetic resonance imaging of brain and bone-marrow aspiration were normal. Fine-needle-aspiration-cytology of cervical lymph nodes demonstrated Cryptococcus. Serum latex-agglutination test showed a positive titer (1:256). Cryptococcus culture was sterile. The patient received intravenous liposomal amphotericin-B and oral flucytosine for 8 weeks followed by oral fluconazole. Disseminated cryptococcosis with involvement of reticuloendothelial and dermatological systems is ra...
Dermoscopic observations in disseminated cryptococcosis with cutaneous involvement
Journal of The European Academy of Dermatology and Venereology, 2017
A 26-year-old female patient with a history of intravenous drug abuse, diagnosed with acquired immunodeficiency syndrome (AIDS) 6 months before. AIDS defining disease was Pneumocystis jiroveci pneumonia. The patient presented with severely decreased CD4 cell count of 7 cells/mm 3 and relatively low HIV viral load of 281 copies/mL. Shortly after initiation of antiretroviral therapy (ART), was diagnosed with disseminated cryptococcosis with central nervous system and skin involvement. Initial cutaneous presentation was a solitary tumour of the chin, covered with a necrotic crust. After 2 weeks of induction treatment with amphotericin B and flucytosine, eradication of C. neoformans from central nervous system was confirmed with negative cerebral fluid culture. Improvement in neurological condition and partial regression of the skin tumour was observed. Consolidation therapy with fluconazole (400 mg per day) was recommended for 8 weeks, followed by secondary prophylaxis with fluconazole (200 mg per day), according to European AIDS Clinical Society Guidelines. 1 Six months later the patient was readmitted to the hospital due to severe headache, fever and vomiting with concomitant facial skin lesions (Fig. 1a). Dermoscopy revealed the presence of white structureless areas with or without linear irregular and branched vessels of different size, surrounded with yellow structureless yellowish halo (Fig. 1b-e). Based on laboratory investigations (increase of CD4 cell count of 171 cells/mm 3 , negative microbiological examination of cerebrospinal fluid) and magnetic resonance imaging of central nervous system, Cryptococcal Immune Reconstitution
Cryptococcal parotid involvement: an uncommon localization of Cryptococcus neoformans
Medical Mycology, 2006
We describe a cryptococcal infection localized in the parotid gland of an otherwise healthy 72-year-old woman. The patient presented with a painful, approximately 4.5 cm diameter mass in the anterior region of her right ear. Her symptoms were mild and uncharacteristic. The patient had previously fallen on her face in her garden, causing the loss and breakage of her dentures. Since the soil of the garden contained chicken droppings, it is quite likely that the oral prothesis became contaminated on contacting the soil. The fungus probably entered the parotid gland through the traumatization of the posterior lateral wall of her oral cavity by her broken denture. Numerous intra-and extracellular cryptococcal yeast cells were observed in both histopathological and mycological slide preparations. The yeastlike fungus was recovered in cultures inoculated with tissue collected through three biopsies of her parotid region. The isolates were identified as Cryptococcus neoformans by classical mycology methods and found to be susceptible, in vitro, to fluconazole, amphotericin B and flucytosine. Fluconazole treatment (400 mg/d, for 6 months) was started and the patients facial swelling resolved and the pain significantly reduced within 5 weeks of the initiation of treatment. While fungal infection of the parotid gland have been reported, to our knowledge, this is the first description of a non-disseminated primary parotid infection due to C. neoformans.