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Related Experiment Videos

Cryptococcoma of the sacrum.

H M Noh1, B S Kuszyk, E K Fishman

  • 1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

Skeletal Radiology
|March 6, 1999
PubMed
Summary
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A sacral cryptococcoma, a fungal bone infection, was the first sign of systemic cryptococcosis in an autoimmune hepatitis patient on steroids. This bone lesion preceded other symptoms, leading to the diagnosis of a widespread fungal infection.

Area of Science:

  • Infectious Diseases
  • Immunology
  • Rheumatology

Background:

  • Systemic cryptococcosis is a serious fungal infection, often seen in immunocompromised individuals.
  • Autoimmune hepatitis patients on long-term immunosuppressive therapy are at increased risk.
  • Chronic steroid therapy can predispose individuals to opportunistic infections like cryptococcosis.

Observation:

  • A patient with autoimmune hepatitis on chronic steroid therapy presented with a sacral cryptococcoma.
  • The bone lesion was the sole initial clinical manifestation of systemic cryptococcosis.
  • No other overt signs of disseminated fungal infection were initially present.

Findings:

  • The sacral bone lesion served as the primary indicator of systemic cryptococcal infection.

Related Experiment Videos

  • The cryptococcoma preceded the development of other clinical manifestations of the disease.
  • This case highlights the potential for focal bone lesions to be the earliest sign of systemic fungal spread.

    • Implications:

    • Early recognition of focal bone lesions in immunocompromised patients is crucial for diagnosing systemic infections.
    • This case underscores the importance of considering opportunistic infections in patients with autoimmune diseases on immunosuppressive treatment.
    • Sacral cryptococcoma can be an unusual but critical presenting sign of disseminated cryptococcosis.