Disseminated cryptococcosis with extensive cutaneous involvement in a previously healthy adult: a rare case report

Cryptococcosis is an opportunistic fungal infection that predominantly affects immunocompromised individuals but may also cause disseminated disease in previously healthy individuals. We report a previously healthy 31-year-old man who developed extensive infiltrated erythematous papules and plaques after granulomatous mesenteric lymphadenitis presenting as acute abdomen. Skin biopsy revealed encapsulated yeast forms consistent with cryptococcosis, although fungal culture was negative. Imaging demonstrated pulmonary, lymphatic, and hepatobiliary involvement. HIV testing was negative, and no known underlying immunosuppressive condition was identified. Treatment with liposomal amphotericin B plus flucytosine followed by fluconazole resulted in complete recovery. Histopathology was essential for diagnosis despite a negative fungal culture.