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Case report. Cryptococcal cellulitis showing necrotizing vasculitis.

M Kimura, E Kadota, T Satou

    Mycoses
    |June 21, 2001
    PubMed
    Summary
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    Cryptococcal cellulitis, a rare fungal infection, can mimic bacterial infections in immunocompromised patients. This case highlights the importance of considering fungal causes, even with unusual presentations like necrotizing vasculitis.

    Area of Science:

    • Mycology
    • Dermatology
    • Infectious Diseases

    Background:

    • Refractory anemia patients on systemic corticosteroids are immunocompromised.
    • Cellulitis is common, but fungal causes are rare.
    • Cryptococcus is an opportunistic pathogen.

    Observation:

    • A 65-year-old woman with refractory anemia developed right cubital fossa cellulitis after prolonged corticosteroid use.
    • Initial empirical treatment for bacterial cellulitis was ineffective.
    • Histological examination revealed Cryptococcus as the causative agent.

    Findings:

    • The fungal infection presented as suppurative inflammation with abscesses.
    • Necrotizing vasculitis, a rare finding in cryptococcosis, was observed.
    • The patient's cellulitis resolved with local treatment.

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    Implications:

    • This case underscores the need for considering fungal infections in refractory cellulitis, especially in immunocompromised individuals.
    • While local treatment was effective here, systemic antifungal therapy is generally recommended for cryptococcal cellulitis.
    • The presence of necrotizing vasculitis highlights a rare but severe manifestation of fungal infection.