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Orthopedic Manifestations of Disseminated Cryptococcal neoformans Infection in an Immunocompromised Patient: a Case
David Yatsonsky1, Jenna Gunn2, Kelsee Zajac2
1Department of Orthopaedic Surgery, The University of Toledo Medical Center, Toledo, OH.
Introduction:
Cryptococccus neoformans is a fungus which typically presents in immunocompromised hosts, commonly presenting as meningoencephalitis. There have been very few documented incidents of intramuscular manifestations of this pathogen.
Case Report:
We report on a case of a 45-year-old caucasian male with disseminated Cryptococcus neoformans who developed cryptococcal intramuscular abscesses of all extremities and osteomyelitis of the left upper limb. Clinical treatment and surgical debridement of the forearm was performed. Persistent infection resulted in a left humeral amputation and ultimately the patient's death. This is one of the few documented intramuscular abscesses of Cryptococcus neoformans.
Conclusion:
Orthopedic manifestations of cryptococcal infections are rare; however, awareness and prompt diagnosis may improve outcomes.
Insights
This case report details a rare instance of disseminated Cryptococcus neoformans leading to intramuscular abscesses and osteomyelitis. Despite aggressive treatment, the patient succumbed to the infection, highlighting the challenges of managing this fungal pathogen.
Area of Science:
- Infectious Diseases
- Mycology
- Clinical Case Studies
Background:
- Cryptococcus neoformans commonly causes meningoencephalitis in immunocompromised individuals.
- Intramuscular manifestations of Cryptococcus neoformans are exceptionally rare in medical literature.
Observation:
- A 45-year-old male presented with disseminated Cryptococcus neoformans infection.
- The patient developed cryptococcal intramuscular abscesses in all extremities and osteomyelitis of the left upper limb.
Findings:
- Despite surgical debridement and clinical treatment, the infection persisted.
- The patient ultimately required a left humeral amputation and died from the disseminated fungal infection.
Implications:
- This case underscores the infrequent but severe orthopedic complications of Cryptococcus neoformans.
- Increased awareness and prompt diagnosis of rare presentations are crucial for potentially improving patient outcomes.
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