Disseminated cryptococcosis with recurrent multiple abscesses in an immunocompetent patient: a case report and literature review.

Background: Cryptococcus neoformans is frequently present as an opportunistic pathogen mainly affecting immunocompromised populations. Disseminated C. neoformans infection in immunocompetent population is rare and usually involves lung and central nerve system. Cryptococcus from biologic samples can...

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Published in:BMC Infectious Diseases Vol. 17; pp. 1 - 7
Main Authors: Qiaoling Ruan, Yimin Zhu, Shu Chen, Liping Zhu, Shu Zhang, Wenhong Zhang, Ruan, Qiaoling, Zhu, Yimin, Chen, Shu, Zhu, Liping, Zhang, Shu, Zhang, Wenhong
Format: case study research Journal Article
Published: BioMed Central 5/30/2017
Online Access:View this record in EBSCOhost
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      dt: 5/30/2017
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      pub: BioMed Central
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        10.1186/s12879-017-2459-9
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        atl: Disseminated cryptococcosis with recurrent multiple abscesses in an immunocompetent patient: a case report and literature review.
      aug:
        au:
          Qiaoling Ruan
          Yimin Zhu
          Shu Chen
          Liping Zhu
          Shu Zhang
          Wenhong Zhang
          Ruan, Qiaoling
          Zhu, Yimin
          Chen, Shu
          Zhu, Liping
          Zhang, Shu
          Zhang, Wenhong
        affil: Department of infectious disease, Huashan Hospital of Fudan University, Shanghai, China
      sug:
        subj:
          Amphotericin B Therapeutic Use
          Cryptococcosis Etiology
          Cryptococcosis Diagnosis
          Antifungal Agents Therapeutic Use
          Spine
          Abscess Microbiology
          Cryptococcus
          Spine Microbiology
          Immunocompromised Host
          Human
          Aged
          Male
          Agglutination Tests
          Cryptococcosis Drug Therapy
          Aged: 65+ years
          Male
      ab: Background: Cryptococcus neoformans is frequently present as an opportunistic pathogen mainly affecting immunocompromised populations. Disseminated C. neoformans infection in immunocompetent population is rare and usually involves lung and central nerve system. Cryptococcus from biologic samples can easily grow on routine fungal and bacterial culture media. Besides, cryptococcal latex agglutination test has been established as a reliable diagnostic tool with overall sensitivities of 93-100%.Case Presentation: We report a rare disseminated cryptococcosis case which presented with chronic recurrent multiple abscess in an immunocompetent male involving skin, lung, spine and iliac fossa without evidence of central nerve system involving. The results of serum cryptococcal latex agglutination tests and standard microbial cultures were negative. The patient underwent empirical anti-bacterial and anti-tuberculosis therapy which turned out to be effectless. Finally, bedside inoculation of the pus was carried out and revealed Cryptococcus neoformans, which was confirmed by polymerase chain reaction. After the administration of anti-fungal drugs including liposomal amphotericin B, the patient recovered from fever and paraplegia.Conclusions: This case reveals an uncommon pattern of disseminated C. neoformans infection in immunocompetent population presented with chronic multiple abscess and without central nerve system involving. Negative routine microbial cultures may not necessarily rule out cryptococcosis, especially in early stage. Besides, cryptococcal latex agglutination test does have a chance of false negative, which might be related with "capsule-deficiency". Moreover, this phenomenon could be related with low-grade virulence and relative long illness duration.
      pubtype: Academic Journal
      doctype:
        case study
        research
        Journal Article
      ougenre: Article
    language: English
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