Disseminated cryptococcosis presenting as palpable purpura

Area of Science:

• Infectious Diseases
• Oncology
• Dermatology

Background:

• Diffuse histiocytic lymphoma (DHL) is an aggressive non-Hodgkin lymphoma.
• Disseminated fungal infections, including cryptococcosis, can occur in immunocompromised patients.
• Cancer therapies can lead to significant immunosuppression and thrombocytopenia.

Observation:

• A patient with diffuse histiocytic lymphoma developed disseminated cryptococcosis.
• The initial clinical manifestation was palpable purpura.
• The patient was thrombocytopenic due to cancer treatment.

Findings:

• The presentation of palpable purpura was previously unreported in disseminated cryptococcosis.
• Cryptococcal vascular injury is proposed as the mechanism for the purpuric manifestation.
• Thrombocytopenia in the cancer patient likely contributed to the purpuric presentation.

Implications:

• Purpuric presentations of disseminated fungal infections may increase with more aggressive cancer therapies.
• Clinicians should consider fungal infections in immunocompromised patients presenting with purpura.
• Early recognition and treatment are crucial for managing disseminated fungal infections in cancer patients.