Multiple cutaneous swellings in an immunocompetent host: cryptococcosis overlooked

Abstract

Recently, there has been an increase in the incidence of cryptococcosis even among immunocompetent patients. We present a case of multiple subcutaneous swellings later developing into a non-healing ulcer caused by Cryptococcus in a 60 year-old immunocompetent male along with a brief review of clinical presentations of cutaneous cryptococcosis in immunocompetent and immunocompromised individuals. A high index of suspicion is desired in view of possible dissemination and variable non-specific clinical presentations.

Disseminated cutaneous cryptococcosis in an immunocompetent elderly long‐term pigeon fancier

“…There have been few reports of immunocompetent patients with multiple skin lesions caused by C. neoformans . As far as the authors know, only five cases excluding ours have been reported in the past (Table ) . Three cases were negative for serum C. neoformans antigen, and five showed no lesions other than skin.…”

“…As far as the authors know, only five cases excluding ours have been reported in the past ( Table 2). [3][4][5][6][7] Three cases were negative for serum C. neoformans antigen, and five showed no lesions other than skin. None of those reports determined the cause of multiple skin lesions in their patients.…”

Primary cutaneous cryptococcosis in an immunocompetent man: A case report

“…Immunocompromised hosts are characterized by multiple lesions, typically in the trunk or lower extremities. 16,19 A diagnosis of PCC should be considered a diagnosis of exclusion, because cutaneous lesions are a symptom of systemic cryptococcosis. 2,19,20 Extensive work-ups including a detailed history, physical examination, and laboratory examination are essential to exclude dissemination.…”

“…16,19 A diagnosis of PCC should be considered a diagnosis of exclusion, because cutaneous lesions are a symptom of systemic cryptococcosis. 2,19,20 Extensive work-ups including a detailed history, physical examination, and laboratory examination are essential to exclude dissemination. A lumbar puncture is indicated when symptoms of central nervous system (CNS) involvement are present; however, its usefulness is debatable in the absence of localizing signs.…”

“…A lumbar puncture is indicated when symptoms of central nervous system (CNS) involvement are present; however, its usefulness is debatable in the absence of localizing signs. 9,19 Underlying immunodeficiency should also be evaluated. 4,9,16 Because the optimal treatment regimen for cutaneous cryptococcosis is not well established, treatment usually varies according to the extent of disease and host immunocompetence.…”