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Related Experiment Videos

Cryptococcosis during systemic glucocorticosteroid treatment.

A I Lauerma1, L Jeskanen, T Rantanen

  • 1Department of Dermatology, Helsinki University Central Hospital, Helsinki, Finland.

Dermatology (Basel, Switzerland)
|November 13, 1999
PubMed
Summary

A patient with sarcoidosis developed a skin infection caused by Cryptococcus neoformans (cryptococcosis) while on long-term steroid treatment. Early diagnosis and combination antifungal therapy led to successful recovery.

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Area of Science:

  • Medical Mycology
  • Dermatology
  • Infectious Diseases

Background:

  • Cryptococcosis is an opportunistic fungal infection primarily affecting immunocompromised individuals.
  • Systemic glucocorticosteroids can increase the risk of opportunistic infections like cryptococcosis.
  • Sarcoidosis is an inflammatory disease that may necessitate immunosuppressive therapy.

Observation:

  • A patient with a 4-year history of lung sarcoidosis treated with systemic glucocorticosteroids developed a progressive papular and ulcerative skin eruption.
  • Initial skin biopsies showed granulomatous inflammation, leading to a misdiagnosis of refractory sarcoidosis.
  • Despite treatment for sarcoidosis, the skin lesions persisted and worsened over a year.

Findings:

  • A second skin biopsy and fungal culture definitively identified Cryptococcus neoformans as the causative agent.

Related Experiment Videos

  • Cryptococcal antigen detection in blood and cerebrospinal fluid confirmed disseminated infection.
  • The patient's condition improved significantly with a combination of amphotericin B and flucytosine, followed by fluconazole maintenance therapy.

    • Implications:

    • This case highlights the importance of considering opportunistic fungal infections in immunocompromised patients presenting with unusual dermatological manifestations.
    • Prompt and accurate diagnosis of cryptococcosis is crucial for effective treatment and patient outcomes.
    • Long-term immunosuppressive therapy requires vigilant monitoring for potential infectious complications.