[Mesenteric cryptococcal lymphadenitis: report of one case]

Area of Science:

• Medical Mycology
• Infectious Diseases
• Gastroenterology

Background:

• Cryptococcosis is an invasive fungal infection primarily caused by Cryptococcus neoformans.
• It predominantly affects immunocompromised individuals, often presenting as meningeal infection.
• Intra-abdominal cryptococcal infections are exceptionally rare clinical occurrences.

Observation:

• A 21-year-old, HIV-positive male undergoing treatment for meningeal cryptococcosis developed acute abdominal symptoms mimicking appendicitis.
• Surgical exploration revealed enlarged, conglomerated mesenteric lymph nodes with a macroscopically normal appendix.
• The excised lymph nodes and appendix were subjected to pathological examination.

Findings:

• Pathological analysis confirmed intra-abdominal cryptococcal lymphadenitis.
• The appendix was found to be macroscopically and microscopically normal, ruling out appendicitis.
• This case demonstrates an unusual presentation of cryptococcosis in the abdominal cavity.

Implications:

• Highlights the importance of considering rare opportunistic infections in immunocompromised patients with atypical presentations.
• Suggests that abdominal pain in HIV-positive patients with cryptococcosis may not always be due to common causes like appendicitis.
• Underscores the need for thorough pathological examination of surgical specimens in suspected cases of opportunistic infections.