Primary Cutaneous Cryptococcosis in an Immunocompetent Host: Case Report and Review of the Literature

Abstract

We report a 46-year-old male who developed cellulitis of his third right finger after being injured with a metallic object. Cryptococcus neoformans var. neoformans was isolated from both the skin and the metallic object. Systemic cryptococcosis and immunosuppression was excluded by appropriate tests. Complete healing was achieved after 10 months of itraconazole 100 mg/12 h and surgical excision of the remaining lesion. Our literature review shows another 16 cases of primary cutaneous cryptococcosis in nonimmunocompromised hosts. The clinical, mycological and therapeutic characteristics of these patients are reviewed.

Primary Cutaneous Cryptococcosis and Secondary Antigenemia in a Patient with Long-Term Corticosteroid Therapy

“…PCC can develop independently of the immunocompetence of the host [18] and is preferentially found in elderly patients [8]. The long-term usage of systemic corticosteroids, the most common risk factor for immunosuppression in patients with cutaneous cryptococcosis [18], probably was responsible for the rapid and severe clinical course resembling necrotizing fasciitis in our patient.…”

“…HIV-infected patients or patients with chronic immunosuppressive medical treatment. However, there are also some reports of cryptococcosis in immunocompetent individuals [8,9]. The infection is usually transmitted via airborne organisms and initially affects the respiratory tract.…”

Primary Cutaneous Cryptococcosis in an Eight-year-old Immunocompetent Child: How to Treat?

“…However, in the latter, cryptococcosis of the skin most frequently is due to secondary dissemination. In an immunocompetent patient traumatic inoculation of the infectious agent may cause a localized cutaneous infection, which is a separate clinical entity, named primary cutaneous cryptococcosis (PCC) [6,21,24]. Treatment regimens for PCC range from diverse anti-fungal medications to surgery alone [17,21,24].…”

Consenso em criptococose: 2008

“…Múltiplas apresentações clínicas podem ocorrer, entretanto lesões semelhantes ao molusco contagioso (lesão papulosa ou maculopapular com centro umbilicado ou ulcerado) têm sido observadas com freqüência. São descritas manifestações cutâneas variadas: papulosas, nodulares, celulite, abscessos, úlceras, erupções acneiformes, pioderma gangrenoso-like, herpes-like, dentre outras 92 .…”