Bone marrow cryptococcosis in an HIV-infected patient: A case report and literature review

Cryptococcosis is a common opportunistic fungal infection in immunocompromised individuals. It is typically isolated from cerebrospinal fluid, sputum, or skin lesions. However, disseminated cryptococcosis involving the bone marrow is an extremely rare occurrence.

This case describes a 34-year-old male patient living with HIV who developed fever, abdominal pain, and pancytopenia. Diagnostic evaluation, including bone marrow aspiration and biopsy, revealed encapsulated yeasts consistent with Cryptococcus sp. Although blood and cerebrospinal fluid cultures failed to identify fungal agents, the diagnosis of isolated bone marrow cryptococcosis was confirmed. A literature review of 21 previously reported cases (up to October 2024) was conducted, revealing a predominance of immunocompromised patients, with male patients being more frequently affected. Cytopenia was a common finding in all cases, and bone marrow biopsy was essential for diagnosis. Treatment protocols remain unstandardized.

Bone marrow cryptococcosis, while rare, should be considered in the differential diagnosis of pancytopenia in immunocompromised patients, particularly those with HIV.