Primary cutaneous cryptococcosis in a renal transplant recipient: case report

Abstract

We report a kidney transplant recipient with severe skin- and soft-tissue infection mimicking necrotising fasciitis. Patient failed to respond to empirical antibiotic therapy for presumed bacterial cellulitis. Culture of aspirate from the wound and tissue samples revealed Cryptococcus neoformans. No signs of systemic cryptococcal infection were found. After antifungal treatment and surgical intervention, complete healing was achieved. Clinical and microbiological characteristics of this patient are discussed. Our case indicates that primary cutaneous cryptococcosis must be included in the differential diagnosis of severe cellulitis in solid organ transplant recipients not responding to broad-spectrum antibiotic regimens. In our case, prompt diagnosis and treatment could dramatically modify the outcome.

Umbilicated papules on the bilateral upper and lower extremities

“…In addition, patients with cryptococcosis often report exposure to contaminated environments that patients with molluscum contagiosum may not. Case reports have also identified cases of cryptococcosis clinically mimicking other dermatologic diseases including necrotizing fasciitis [7], keloid [8], and basal cell carcinoma [9]. Thus, a broad differential diagnosis is essential for patient evaluation and management to avoid missed diagnosis.…”

A 36-Year-Old Renal Transplant Recipient Female with Leg Ulcer: A Case Report and Brief Review

“…However, our patient had no history of cutaneous injury, outdoor activities, and exposure to bird droppings. In the past few years, it became evident that direct inoculation of the pathogen through a minor skin wound can cause primary infection of the skin [ 11 ].…”

Criptococosis cutánea localizada en paciente trasplantada renal: una entidad infrecuente

“…En nuestra paciente, no identificamos otro sitio de compromiso tisular durante la hospitalización ni los meses de seguimiento y el CRAG tampoco fue detectado [4] . Sin embargo, otros autores plantean inclusive que la antigenemia positiva no debe ser criterio para excluir criptococosis cutánea primaria [14] .…”