Primary Cutaneous Cryptococcosis: A Distinct Clinical Entity

Neuville, Ségolène; Dromer, Françoise; Morin, O.; Dupont, B.; Ronin, Olivier; Lortholary, Olivier

doi:10.1086/345956

Cited by 210 publications

(227 citation statements)

References 84 publications

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“…Cellulitis, ulceration, and whitlow are the most common clinical features of primary cutaneous cryptococcosis [13,14]. The frequency of cutaneous involvement in disseminated infection is higher in liver transplant recipients receiving tacrolimus or in patients infected with serotype D [15].…”

Section: Discussionmentioning

confidence: 99%

Cryptococcal meningitis with secondary cutaneous involvement in an immunocompetent host

Tabassum

Rahman

Herekar

et al. 2013

J Infect Dev Ctries

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Cryptococcosis is a potentially fatal fungal disease caused by variants of Cryptococcus neoformans species. The respiratory tract is the usual portal of entry, with a peculiar predilection to invade the central nervous system. The skin can be secondarily involved in disseminated infection or be exceptionally involved as primary cutaneous infection by inoculation. The disease is mostly seen in immunodeficiency states. The diagnosis is frequently unsuspected in immunocompetent patients. We report a case of disseminated cryptococcal meningitis in an immunocompetent young adult. The cutaneous eruption prompted the accurate diagnosis. The patient, a 20-year-old female, had fever, cough, headache and intractable vomiting for the past two months and was being managed as a case of tuberculous meningitis. Two weeks after starting antituberculous treatment she developed umbilicated papules on the head and neck region. Necessary laboratory workup identified C. neoformans in cerebrospinal fluid (CSF) and skin specimens. The titers of cryptococcal antigen were measured in CSF and serum for diagnostic and prognostic purposes. Anti-fungal treatment resulted in regression of the cutaneous lesions and resolution of systemic complaints. The case highlights the need for high degree of suspicion, especially in healthy young adults, in the diagnosis of cryptococcosis. The cutaneous eruptions can be the first manifestation or a diagnostic clue of enormous significance.

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Section: Discussionmentioning

confidence: 99%

Cryptococcal meningitis with secondary cutaneous involvement in an immunocompetent host

Tabassum

Rahman

Herekar

et al. 2013

J Infect Dev Ctries

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show abstract

“…A 69-year-old woman who had lived in a rural area and had and scattered, located on both clothed and exposed areas (most commonly on the head and neck) [4]. Almost every type of skin lesion, however, can appear during disseminated cryptococcosis.…”

Section: Case Reportmentioning

confidence: 99%

“…Therefore, careful investigation is required to ascertain a diagnosis of PCC, as some features can be used to differentiate PCC from secondary infection [4]. This work-up should include serum cryptococcal antigen, blood, urine, and sputum cultures, a chest X-ray, and thorough dermatologic examination.…”

Section: Case Reportmentioning

confidence: 99%

“…As such, cryptococcal skin disease is commonly regarded as a marker of a disseminated disease state. Recently, it was found that primary cryptococcocal skin and soft [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Among these manifestations, cellulitis is more common in immunocompromised patients and rapidly progresses to deep structures [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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