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[Cutaneous cryptococcosis in AIDS patient].

J Gasiorowski1, G Szybejko-Machaj, A Machaj

  • 1Katedra i Klinika Chorób Zakaźnych Akademii Medycznej we Wrocławiu.

Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego
|August 16, 2001
PubMed
Summary

This case highlights cryptococcal infection presenting as molluscum contagiosum-like skin lesions in an HIV-positive individual. Prompt skin biopsy is crucial for diagnosing cutaneous cryptococcosis.

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Area of Science:

  • Infectious Diseases
  • Dermatology
  • Mycology

Background:

  • Highly active antiretroviral therapy (HAART) effectively manages Human Immunodeficiency Virus (HIV) infection by reducing viral load and increasing CD4+ T cell counts.
  • Cutaneous manifestations in HIV-infected individuals can be diverse and sometimes mimic other conditions.
  • Cryptococcus neoformans is an opportunistic fungal pathogen that can cause severe infections, particularly in immunocompromised hosts.

Observation:

  • A 45-year-old man with Acquired Immunodeficiency Syndrome (AIDS) on HAART developed umbilicated skin lesions resembling molluscum contagiosum on his face, neck, and chest.
  • Histopathology and fungal cultures from a skin biopsy confirmed the presence of Cryptococcus neoformans.
  • Cryptococcal antigens were detected in the patient's blood, indicating systemic involvement.

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Findings:

  • The skin lesions showed a histopathological pattern consistent with cryptococcal infection, not molluscum contagiosum.
  • Treatment with amphotericin B led to the regression of the cutaneous lesions.
  • This case underscores the importance of considering fungal infections in the differential diagnosis of atypical skin lesions in HIV patients.

Implications:

  • Skin biopsies are essential for accurate diagnosis of cutaneous cryptococcosis in HIV-infected individuals presenting with suspicious lesions.
  • Cutaneous cryptococcosis, as seen in this case, may represent an immune reconstitution inflammatory syndrome (IRIS) in some HIV patients.
  • Early and accurate diagnosis is critical for appropriate treatment and management of cryptococcal infections in immunocompromised populations.