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Cryptococcosis presenting as a neck mass

D M Schmidt1, J A Sercarz, K F Kevorkian

  • 1Division of Head and Neck Surgery, University of California-Los Angeles School of Medicine, USA.

The Annals of Otology, Rhinology, and Laryngology
|September 1, 1995
PubMed
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A rare neck mass caused by cryptococcal infection led to bone destruction and neurological deficits in a healthy patient. Prompt diagnosis and combination therapy, including antifungals and surgery, were crucial for recovery.

Area of Science:

  • Infectious Diseases
  • Oncology
  • Neurology

Background:

  • Cryptococcosis is a fungal infection typically affecting immunocompromised individuals.
  • Head and neck manifestations are uncommon, especially in healthy patients.
  • This case highlights cryptococcosis presenting as a destructive neck mass.

Observation:

  • A rare case of cryptococcal infection presenting as a neck mass in an otherwise healthy individual.
  • The mass caused lytic destruction of cervical vertebrae and focal neurologic deficits.
  • Lesions were found in the skull, femur, and humerus, but not the lungs or CNS.

Findings:

  • The patient was treated with amphotericin B, flucytosine, and fluconazole.
  • Surgical debridement was necessary for complete resolution.

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  • The infection demonstrated unusual bone and neurological involvement.

    • Implications:

    • This case underscores the importance of considering cryptococcosis in the differential diagnosis of neck masses, even in healthy individuals.
    • It highlights the potential for significant bone destruction and neurological compromise.
    • Aggressive and multimodal treatment is essential for managing disseminated cryptococcosis.