Cryptococcal infection presenting as soft tissue abscess and arthritis: Case report.

Rationale: Cryptococcal infection has been documented in immunocompromised patients. AIDS and renal transplant recipients account for majority of the cases. Most cases present with central nervous system or disseminated disease, with only few presenting soft tissue, bone, and joint manifestations.Pa...

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Published in:Medicine Vol. 100; no. 28; pp. 1 - 6
Main Authors: Yong Jin Cho, Song Iy Han, Sung-Chul Lim, Cho, Yong Jin, Han, Song Iy, Lim, Sung-Chul
Format: case study Journal Article
Published: Lippincott Williams & Wilkins 7/16/2021
Online Access:View this record in EBSCOhost
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      dt: 7/16/2021
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      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        atl: Cryptococcal infection presenting as soft tissue abscess and arthritis: Case report.
      aug:
        au:
          Yong Jin Cho
          Song Iy Han
          Sung-Chul Lim
          Cho, Yong Jin
          Han, Song Iy
          Lim, Sung-Chul
        affil: Department of Orthopedic Surgery, College of Medicine, Chosun University, Gwangju, Korea.
      sug:
        subj:
          Abscess Microbiology
          Cryptococcosis Diagnosis
          Fluconazole Therapeutic Use
          Immunocompromised Host Physiology
          Kidney Transplantation
          Arthritis Physiopathology
          Cryptococcus
          Heterocyclic Compounds Therapeutic Use
          Abscess Drug Therapy
          Diagnosis, Differential
          Male
          Aged
          Female
          Arthritis Diagnosis
          Abscess Diagnosis
          Cryptococcosis Physiopathology
          Antifungal Agents Therapeutic Use
          Cryptococcosis Drug Therapy
          Middle Age
          Scales
          Arthritis Impact Measurement Scales
          Aged: 65+ years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Rationale: Cryptococcal infection has been documented in immunocompromised patients. AIDS and renal transplant recipients account for majority of the cases. Most cases present with central nervous system or disseminated disease, with only few presenting soft tissue, bone, and joint manifestations.Patient Concerns: We present a case of soft tissue mass in a 66-year-old female renal transplant recipient and that of arthritis in a 64-year-old immunocompetent man who presented pseudogout arthropathy. Chest radiographies of both cases were negative. Biopsy revealed cryptococcal organisms. Blood culture or cerebrospinal fluid sampling indicated positive results for cryptococcal antigen.Diagnosis: Cryptococcus neoformans was recovered in the wound culture.Interventions: The patients received intravenous fluconazole and flucytosine, followed by oral fluconazole administration.Outcomes: Symptomatic improvements were achieved and no subsequent relapses were observed.Lessons: The authors experienced 2 cases of cryptococcosis with very unusual clinical presentation. Early clinical suspicion and serum cryptococcal antigen testing can help in rapid appropriate diagnosis in immunocompetent as well as immunocompromised patients even in the absence of pulmonary involvement.
      pubtype: Academic Journal
      doctype:
        case study
        Journal Article
      ougenre: Article
    language: English
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