Related Experiment Video
Updated: Feb 1, 2026
Macrophage Cholesterol Depletion and Its Effect on the Phagocytosis of Cryptococcus neoformans
Published on: December 19, 2014
Chronic skull osteomyelitis due to Cryptococcus neoformans: first case report in an HIV-infected patient
Natanael Sutikno Adiwardana1, Juliana de Angelo Morás1, Leandro Lombo Bernardo1
1Instituto de Infectologia Emilio Ribas, Programa de Residência Medica, São Paulo, SP, Brazil.
Abstract:
Osteomyelitis due to Cryptococcus neoformans are described in mostly 10% of patients with disseminated cryptococcosis, being direct inoculation even more uncommon. We report the case of an HIV-infected patient with history of recurring itching on his scalp and repetitive local trauma. For eighteen months, he noticed a painful and slow growing lump on his scalp. He was submitted to an excisional biopsy of the lesion but no etiological diagnosis was identified. After this procedure, the post-surgical wound never completely healed. At admission, the patient presented nausea and headache for three days and an open orifice into his skull. Investigations confirmed meningitis and skull osteomyelitis caused by Cryptococcus neoformans. He was treated with bone debridement and combined systemic antifungals, showing good clinical and laboratorial outcome. Cryptococcal disease should be included in the differential diagnoses of chronic osteomyelitis in HIV-infected patients and trauma is a possible source of infection.
Insights
Cryptococcus neoformans can cause skull osteomyelitis, especially in HIV patients with scalp trauma. Early diagnosis and treatment with antifungals are crucial for recovery.
Area of Science:
- Infectious Diseases
- Mycology
- Neurosurgery
Background:
- Osteomyelitis is a serious bone infection.
- Cryptococcus neoformans is an opportunistic fungal pathogen.
- Disseminated cryptococcosis occurs in immunocompromised individuals.
Observation:
- A case of an HIV-infected patient with a chronic, non-healing scalp lesion is presented.
- The patient experienced recurrent scalp itching and local trauma.
- A painful, slow-growing lump on the scalp preceded meningitis and skull osteomyelitis.
Findings:
- Skull osteomyelitis and meningitis were diagnosed in the patient.
- The causative agent was identified as Cryptococcus neoformans.
- Direct inoculation of the fungus following trauma and biopsy was suspected.
Implications:
- Cryptococcal disease should be considered in the differential diagnosis of chronic osteomyelitis in HIV-infected patients.
- Trauma may serve as a potential entry point for fungal infections leading to osteomyelitis.
- Prompt diagnosis and combined antifungal therapy are essential for favorable outcomes.
Related Concept Videos
01:22Sutures of the Skull
Sutures are immobile joints between adjacent bones of the skull. The narrow gap between the bones is filled with dense, fibrous connective tissue that unites the bones. The long sutures located between the skull bones are not straight but instead follow irregular, tightly twisting paths. These twisting lines tightly...
01:24Data Reporting and Recording
01:08Overview of the Skull
The cranial vault surrounds and protects the brain and houses the middle and inner ear structures. This cavity is bounded superiorly by the rounded top of the skull, which...
01:25Types of Reports I: Hands-off Report
Following are the key components and categories of hand-off reports:
Purpose and Process:
01:21Types of Reports II: Incident or Occurrence Report
Purposes:
In the healthcare industry, reports play a crucial role in documenting incidents within an agency. The primary objective of these reports is to ensure patient safety, uphold the...
01:26Types of Reports III: Telephone and Verbal Reports
Here's an overview of each type:
Telephone Orders