Liver dysfunction as the presenting feature of disseminated cryptococcosis

Abstract

Disseminated cryptococcosis is rare in immunocompetent individuals with central nervous and respiratory systems being the most common initial sites of involvement. Liver dysfunction as a presenting feature of disseminated cryptococcosis has been reported rarely, with the majority of patients being HIV negative and immunocompetent. We report a case of disseminated cryptococcosis in a three-year-old HIV seronegative, immunocompetent male child presenting with obstructive jaundice and lymphadenopathy. Initial diagnosis was made on liver and lymph node biopsy. Lung, skin, central nervous system (CNS) and urinary tract involvement occurred later in the course of disease. Diagnosis was confirmed by serology and culture.

Disseminated cryptococcosis causing liver dysfunction in a pug

“…In humans, hepatic involvement in disseminated cryptococcosis (not associated with prior end-stage liver disease) is also rare, but hepatic failure has been reported as the pri-mary manifestation of cryptococcosis in one case series of two patients 20 and one case report. 21 These cases mimicked other infectious hepatopathies and neoplasia. The overlap of common presenting clinical signs between primary gastrointestinal disease and hepatic disease (e.g., vomiting, diarrhoea, lethargy, inappetence) in dogs may mean that hepatic involvement in cryptococcosis is underdiagnosed.…”

“…In humans, hepatic involvement in disseminated cryptococcosis (not associated with prior end‐stage liver disease) is also rare, but hepatic failure has been reported as the primary manifestation of cryptococcosis in one case series of two patients 20 and one case report 21 . These cases mimicked other infectious hepatopathies and neoplasia.…”