Isolated cryptococcal osteomyelitis in an immune-competent host: a case report

Y Ramkillawan1, H Dawood, N Ferreira

  • 1Department of Internal Medicine, Nelson R Mandela School of Medicine, University of KwaZulu Natal, Pietermaritzburg 3201, South Africa.

Insights

This case report details an extremely rare instance of isolated cryptococcal osteomyelitis in the humerus of an immunocompetent individual. It highlights the unusual presentation of Cryptococcus neoformans infection outside of typical pulmonary or central nervous system involvement.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Orthopedic Surgery

Background:

  • Cryptococcus neoformans is a fungus causing opportunistic infections, primarily in immunocompromised individuals.
  • Pulmonary and central nervous system infections are the most common manifestations.
  • Osseous involvement by Cryptococcus neoformans is rare and typically linked to disseminated disease.

Observation:

  • A 56-year-old immunocompetent male presented with symptoms localized to the humerus.
  • Imaging and biopsy confirmed osteomyelitis of the humerus.
  • Microbiological analysis identified Cryptococcus neoformans as the causative agent.

Findings:

  • The patient was diagnosed with isolated cryptococcal osteomyelitis of the humerus.
  • This presentation is exceptionally rare, particularly in an immunocompetent host.
  • The infection was confined to the bone without evidence of systemic dissemination.

Implications:

  • This case expands the known spectrum of Cryptococcus neoformans infections.
  • It underscores the importance of considering fungal etiologies in osteomyelitis, even in immunocompetent patients.
  • Further research may be warranted to understand the pathogenesis of isolated osseous cryptococcosis.