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A case of primary cutaneous cryptococcosis
D Vogelaers1, M Petrovic, M Deroo
1Department of Internal Medicine, University Hospital Ghent, Belgium.
Summary
A rare fungal skin infection caused by Cryptococcus neoformans was successfully treated in a 77-year-old man. The patient
Area of Science:
- Mycology
- Dermatology
- Infectious Diseases
Background:
- Cryptococcus neoformans is an opportunistic fungal pathogen.
- Primary cutaneous cryptococcosis is rare, particularly in immunocompetent individuals.
- Risk factors include immunosuppression and potential direct inoculation.
Observation:
- A 77-year-old man presented with a large digital ulcer.
- The ulcer had undermined edges and was identified as a cutaneous infection by Cryptococcus neoformans var. neoformans serotype D.
- The patient had a history of long-term steroid treatment for chronic obstructive pulmonary disease.
Findings:
- Successful treatment of the digital ulcer was achieved with a combination therapy.
- Intravenous amphotericin B (750 mg cumulative dose over 12 days) followed by oral fluconazole (600 mg daily for six weeks) led to healing.
- This case highlights a potential risk factor (steroid use) for cutaneous fungal infections.
Implications:
- Early diagnosis and appropriate antifungal therapy are crucial for managing cutaneous cryptococcosis.
- This case underscores the importance of considering fungal infections in patients with chronic skin lesions, especially those with risk factors.
- Further research into primary cutaneous cryptococcosis in diverse patient populations is warranted.