PubMed · 13301704
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C HOOFT, J PINTELON, J CALLENS. 1955. [Meningitis caused by cryptococcus].. https://pubmed.ncbi.nlm.nih.gov/13301704/
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We described a case of cryptococcal mastitis in a 46 years old female patient receiving corticosteroids for sarcoidosis. There was radiological pulmonary deterioration and a cystic lesion was found in the left breast. The mycosis was diagnosed by histopathology and cryptococcal antigens. We emphasized the sarcoid granuloma diagnostic's dilemma an the rare manifestation of cryptococcal infection as mastitis.
The prevalence of specific serotypes of Cryptococcus neoformans in a given area bears on regional epidemiological patterns, the expected spectrum of clinical disease, and predicted response to therapy. In this retrospective study we analyzed the serotypes of 45 degrees C neoformans isolates from 36 North Indian patients with varied clinical presentations. The majority of the isolates were serotype A (87%), and surprisingly, a significant number were serotype B (five isolates, 11%), which caused infection in patients both positive and negative for HIV. One unusual isolate was not typable with factor sera. Study of serotype distribution in patients showed serotypes A and B to be present, respectively, in 92% and 8% of 36 patients. In one apparently immunocompetent patient two serotypes, A and B, were isolated simultaneously from two different sites, lung and scalp abscess. This is the first reported case in which an individual was infected with two serotypes at the same time. In one HIV-infected child serotype A was isolated from blood. Our results suggest that the distribution of serotypes in Indian clinical isolates is different than that found in other regions.
Cryptococcal skin lesions are found in 10 to 15% of patients with disseminated cryptococcosis. Primary skin inoculation by Cryptococcus neoformans is rare but has been reported. We report the first known case of primary cutaneous cryptococcosis in a lung transplant recipient. Our patient, a 57-year-old man, underwent left single-lung transplantation and presented with a nonhealing ulcer 50 months later. Skin histopathology and culture confirmed C. neoformans. Serum and cerebrospinal fluid cryptococcal antigen tests were negative. The lesion healed after treatment with fluconazole. To date, disseminated disease is not evident. Primary cutaneous cryptococcosis has been reported in kidney and liver recipients but not in lung transplantation recipients. Nonhealing ulcers in immunocompromised patients mandate aggressive diagnostic procedures. Differential diagnosis of these cutaneous lesions should consider fungi, including C. neoformans.