Demonstration of Cryptococcus neoformans in a stained bone marrow specimen

Disseminated cryptococcosis is seen with increased frequency in patients with malignant hematologic disease. Usually the diagnosis rests on spinal fluid studies, and little attention has been paid to the direct examination of a bone marrow specimen. A febrile woman with an advanced histiocytic lymphoma was intensively treated with antineoplastic agents; the antemortem diagnosis of cryptococcosis was suspected from direct examination of the bone marrow and was subsequently confirmed by culture. Visualization of fungi in special stained bone marrow specimens could be useful in the initial examination of febrile patients with neoplastic diseases and/or compromised host defenses, and would permit early institution of specific therapy.