Disseminated Cryptococcosis with Cutaneous Lesions

Abstract

A case of disseminated cryptococcosis in an HIV-negative patient presenting with cutaneous lesions is described for the first time in Egypt. The patient, a 16-year-old male, presented with cough, expectoration, loss of weight, and cutaneous lesions, mainly on the face and trunk. The lesions consisted of vegetating crusted plaques discharging purulent to sanguinous fluid and flattened, shiny, erythematous to brownish plaques. Anorexia, headache and personality changes soon followed. Histopathological examination of lesions was highly suggestive of a deep mycosis, particularly cryptococcosis. The fulminant disease advanced with central nervous system involvement. The progression was not arrested when systemic antifungal therapy was administered late in the disease course. Pathological examination of lungs, liver, pancreas and spleen revealed disseminated infection with no evidence of other underlying pathology. Disseminated cryptococcosis is a morbid infection, rare in an area where heightened awareness and raised index of suspicion will surely allow earlier diagnosis, management and better prognosis.

Cryptococcosis in cirrhotic patients

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Petechial, purpuric, and ecchymotic presentation of cutaneous Cryptococcus in mantle cell lymphoma

“…Most commonly, molluscoid, umbilicated or ulcerated papules, nodules, or plaques present with or without background erythema. 1 , 4 , 6 , 7 Presentation with asymptomatic petechial, purpural, or ecchymotic rash is rare although previously described in another thrombocytopenic lymphoma patient. It was postulated that red blood cell extravasation occurred as a result of direct vascular injury by disseminated Cryptococcus .…”

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Case report. Disseminated cutaneous cryptococcosis in an immunocompetent host

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