Cryptococcal disease presenting as necrotizing cellulitis in transplant recipients

Area of Science:

• Infectious Diseases
• Transplant Surgery
• Dermatology

Background:

• Disseminated cryptococcosis typically manifests with skin lesions in immunocompromised individuals.
• Rarely, Cryptococcus neoformans can present as aggressive soft tissue infections like necrotizing fasciitis or myositis.

Observation:

• This study reports three cases of cryptococcal necrotizing soft tissue infection.
• Two cases involved renal transplant recipients, and one involved a heart transplant recipient.

Findings:

• Cryptococcus neoformans infection should be considered in the differential diagnosis of severe skin infections, including cellulitis and necrotizing soft tissue infections.
• The findings highlight the importance of recognizing unusual presentations of fungal infections in transplant patients.

Implications:

• Early recognition and diagnosis of cryptococcal necrotizing soft tissue infections are vital for improving outcomes in immunocompromised patients.
• This underscores the need for a broad differential diagnosis when evaluating severe infections in transplant recipients.