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Published on: July 19, 2021
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[Clinical problems in Medical Mycology: Problem number 57]
Gabriela Santiso1, Fernando Messina1, Matías Gastón Pérez2
1Unidad de Micología, Hospital de Infecciosas Francisco Javier Muñiz, Buenos Aires, Argentina.
Revista Iberoamericana De Micologia
|March 5, 2025
Summary
A disseminated Cryptococcus infection presented atypically with fever, cough, and pleural effusion in an immunocompetent man. Early diagnosis of this yeast infection, despite initial misdirection by onychomycosis, led to prompt treatment and improved prognosis.
Area of Science:
- Infectious Diseases
- Mycology
- Internal Medicine
Background:
- Disseminated fungal infections can present with varied symptoms, challenging timely diagnosis.
- Cryptococcus species are known opportunistic pathogens, particularly in immunocompromised individuals.
Observation:
- A 48-year-old man presented with fever, cough, and chest pain, leading to the discovery of pleural effusion.
- Despite antibiotic treatment for presumed bacterial infection, the patient remained febrile and developed widespread onychomycosis.
- Pleural fluid culture identified yeast as Cryptococcus sp.
Findings:
- The patient was diagnosed with disseminated cryptococcosis with central nervous system involvement.
- The yeast identified was Cryptococcus sp., indicating a serious systemic fungal infection.
Implications:
- This case highlights the importance of considering opportunistic fungal infections, even in seemingly immunocompetent patients.
- Atypical presentations of cryptococcosis, including dermatologic manifestations like onychomycosis, necessitate a broad differential diagnosis.
- Early identification of Cryptococcus species is crucial for initiating appropriate antifungal therapy and improving patient outcomes.
