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Disseminated Skeletal Cryptococcosis: A Case Report.

David Joseph¹, Prannoy Paul², Vishnu Padmanabhan¹

¹Department of Orthopaedics, Government Medical College, Kozhikode, Kerala, India.

Journal of Orthopaedic Case Reports

|August 11, 2025

Summary

This case report highlights a rare instance of disseminated cryptococcosis causing multiple bone lesions in an immunocompromised individual with isolated CD4 lymphocytopenia. Early diagnosis and antifungal treatment are crucial for managing this fungal infection.

Keywords:

Cryptococcus neoformans cryptococcal osteomyelitis cryptococcosis osteomyelitis

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Area of Science:

Infectious Diseases
Mycology
Immunology

Background:

Osteomyelitis is rarely caused by Cryptococcus, particularly in immunocompromised patients.
Disseminated cryptococcosis with bone involvement is an uncommon presentation.

Observation:

A 31-year-old male presented with chronic bone pain and swelling, initially misdiagnosed as tuberculosis.
Imaging revealed multiple osteolytic bone lesions in the femur, pubic bone, and rib.
Fine needle aspiration cytology and fungal cultures confirmed Cryptococcus neoformans infection.

Findings:

The patient had isolated CD4 lymphocytopenia, a risk factor for opportunistic infections.
Successful treatment with antifungal therapy led to symptom resolution.

Implications:

Cryptococcosis should be considered in the differential diagnosis of patients with unexplained bone pain and lytic lesions.
Fungal culture is essential for definitive diagnosis.
Prompt antifungal treatment is vital to prevent severe complications and mortality.