Microbiological Diagnosis: A Key to Successfully Managing Cryptococcal Osteomyelitis Coexisting With Leprosy

Area of Science:

• Mycology
• Infectious Diseases
• Orthopedics

Background:

• Cryptococcus neoformans is an encapsulated yeast-like fungus.
• It typically causes meningitis and disseminated disease, especially in immunocompromised individuals.
• Osseous (bone) lesions are a rare manifestation of cryptococcosis.

Observation:

• A 27-year-old male with a three-year history of leprosy presented with a painful ankle ulcer.
• Incisional biopsy and surgical debridement samples grew Cryptococcus neoformans.
• The patient was diagnosed with cryptococcal osteomyelitis affecting the calcaneus and tibia.

Findings:

• Successful treatment involved liposomal amphotericin B followed by fluconazole.
• This case demonstrates cryptococcal osteomyelitis in an immunocompetent individual with a history of leprosy.
• Cryptococcal osteomyelitis is an uncommon cause of chronic osteolytic lesions.

Implications:

• Cryptococcal osteomyelitis should be considered in the differential diagnosis of chronic osteolytic lesions.
• Early diagnosis and microbiological confirmation are crucial for successful management.
• This highlights the importance of considering rare fungal infections even in immunocompetent patients.