Cutaneous Cryptococccosis Due to Cryptococcus gattii in Immunocompetent Hosts: Case Report and Review

Abstract

Cutaneous cryptococcosis caused by C. gattii, in immunocompent patients is a rare manifestation of disease, and may be one of the first manifestations of disseminated cryptococcosis. We report a case of disseminated cryptococcosis caused by Cryptococcus gattii presenting as cutaneous lesions in an immunocompetent patient. Previously to our report, only five cases of cutaneous involvement by Cryptococcus gattii in immunocompetent patients have been reported in the literature. Risk factors for C. gattii infection included exposure to the eucalypt reservoirs in tropical and subtropical areas. Skin involvement corresponded to the disseminated form of cryptococcosis in the majority of patients, and commonly affected the face and neck with different morphologies including papules, pustules, plaques, ulcers, subcutaneous masses, cellulitis or acneiform lesions. Due to the severity of this infection and the life threatening condition that it represents, clinicians must be aware that cutaneous involvement may be one of the first manifestations of disseminated cryptococcosis caused by C. gattii especially in patients living and coming from endemic areas.

Cryptococcuria as manifestation of disseminated cryptococcosis: Staib agar as a selective identification medium

“…Cryptococcus gattii is a highly unusual cause of skin lesions, cryptococcemia and cryptococcuria 4,15–17 . On the other hand, infections due to C. neoformans can be isolated from blood in up to 63% of patients 4 .…”

Cutaneous Cryptococcosis Mimicking Basal Cell Carcinoma in a Patient with Sézary Syndrome

“…neoformans) found mostly in Europe; and B and C (C. neoformans var. gattii), which are limited to tropical and subtropical areas (2,3).…”

Cryptococcus gattii: a resurgent fungal pathogen

“…Similar to other ‘primary pathogenic fungi’, C. gattii causes disseminated skin and lung lesions that can potentially be misdiagnosed as malignancies 31-33 . Brain infections (meningoencephalitis) caused by C. gattii are reported to respond slowly to standardized therapy, and they require more diagnostic follow-ups than those seen in C. neoformans infections 34-37 .…”