1/12. Case report. Cryptococcal cellulitis showing necrotizing vasculitis.A 65-year-old woman with refractory anaemia who had been treated with systemic corticosteroids for several months developed cryptococcal cellulitis of the right cubital fossa. She was treated empirically for a presumed bacterial cellulitis with little response. Histological examination of debrided tissue revealed Cryptococcus as the causative organism. The tissue reaction involved suppurative inflammation with abscess formation in the dermis and subcutaneous adipose tissue. Necrotizing vasculitis, which has rarely been described in cryptococcosis, was seen in this case. Although the cellulitis was cured by local treatment in this patient, most previous reports recommended systemic antifungal therapy to treat cryptococcal cellulitis.- - - - - - - - - - ranking = 1keywords = cryptococcosis (Clic here for more details about this article) |
2/12. Case report. Cutaneous cryptococcosis in a patient with systemic erythematous lupus.The first case of a cutaneous cryptococcosis associated with systemic erythematous lupus (SLE) diagnosed in our mycology Reference Centre is presented: a 24-year-old female patient diagnosed with SLE, nephrotic syndrome, arterial hypertension, renal insufficiency due to glomerulonephritis type IV and cellulitis in the right thigh and gluteus. cryptococcus neoformans was isolated by cutaneous biopsy and haemoculture. Cryptococcal antigen was detected in serum by the latex agglutination test. As the patient did not respond to fluconazol intravenous treatment, amphotericin b administration was performed. She died of acute renal insufficiency.- - - - - - - - - - ranking = 5keywords = cryptococcosis (Clic here for more details about this article) |
3/12. Disseminated cellulitic cryptococcosis in the setting of prednisone monotherapy for pemphigus vulgaris.Cryptococcal infections are seen mainly in immunocompromised hosts. The cutaneous manifestations of infection can include papules, plaques, nodules, vesicles, ulcers, ecchymosis, and, rarely, cellulitis. Cryptococcal meningitis is a life-threatening complication of this disease. pemphigus vulgaris is a rare auto-immune blistering disease that can also be life-threatening. Treatment of pemphigus commonly entails both corticosteroids and steroid-sparing agents. We present a case of disseminated cryptococcal infection in a patient with pemphigus vulgaris treated with high dose corticosteroids as monotherapy. This case provides an opportunity to discuss the difficulty of managing two potentially mortal conditions in which the treatment of pemphigus vulgaris may exacerbate the disseminated cryptococcal infection.- - - - - - - - - - ranking = 4keywords = cryptococcosis (Clic here for more details about this article) |
4/12. Cryptococcal cellulitis in a patient on prednisone monotherapy for myasthenia gravis.The development of cutaneous cryptococcosis is extremely rare in the human immunodeficiency virus-negative population. The cutaneous manifestations vary greatly, with the rarest presenting as cellulitis. We report a unique case of a 64-year-old woman who had been on prednisone monotherapy for the treatment of myasthenia gravis and subsequently developed cryptococcal cellulitis. This case provides an opportunity to discuss the importance of including cryptococcal cellulitis in the differential diagnosis of cellulitis in a patient on low-dose prednisone who is not responding to empiric antibiotic therapy. Early recognition is crucial as cutaneous manifestations are usually the first sign of disseminated cryptococcosis.- - - - - - - - - - ranking = 2keywords = cryptococcosis (Clic here for more details about this article) |
5/12. Primary cutaneous cryptococcal cellulitis secondary to insect bite in an immunosupressed patient after liver transplantation.Cutaneous cryptococcosis is usually a manifestation of disseminated disease, especially in immunosuppressed patients. Primary cutaneous cryptococcosis has also been described in some patients without evidence of systemic disease. Distinguishing between primary and secondary cutaneous cryptococcosis may be difficult as patients can be asymptomatic or cutaneous lesions may precede systemic involvement by some months. Features supporting primary disease are a history of cutaneous inoculation, and solitary superficial lesions on uncovered parts of the body. We present a liver transplant patient with cutaneous cryptococcal cellulitis subsequent to an insect bite, without systemic involvement and with excellent response to treatment with amphotericin b for 15 days and surgical debridement plus oral fluconazole for 3 months. In immunosupressed patients with cellulitis a cryptococcal infection must be excluded. If cutaneous cryptococcosis is diagnosed, systemic evaluation and prompt lengthy treatment are required.- - - - - - - - - - ranking = 4keywords = cryptococcosis (Clic here for more details about this article) |
6/12. Disseminated cryptococcosis presenting as cellulitis with necrotizing vasculitis.patients with disseminated cryptococcosis infrequently present with cutaneous involvement. skin lesions, when present, are usually multiple and polymorphous in appearance. cellulitis caused by cryptococcus neoformans is rare, and necrotizing vasculitis associated with cryptococcal vascular invasion has not to our knowledge been reported. We report here a case of disseminated cryptococcosis in a renal transplant recipient who had cellulitis and necrotizing vasculitis and in whom a diagnostic skin biopsy allowed for early therapy with cure and salvage of the renal allograft.- - - - - - - - - - ranking = 6keywords = cryptococcosis (Clic here for more details about this article) |
7/12. Cryptococcal cellulitis.Immunocompromised patients are more susceptible to unusual pathogens. The case of an immunocompromised patient who presented with cellulitis as the only manifestation of disseminated cryptococcosis is reported. The literature on cryptococcal cellulitis is reviewed.- - - - - - - - - - ranking = 1keywords = cryptococcosis (Clic here for more details about this article) |
8/12. cellulitis as first clinical presentation of disseminated cryptococcosis in renal transplant recipients.Two renal transplant recipients with cellulitis due to cryptococcus neoformans are described. The patients were treated empirically for a presumed bacterial erysipelas, but without response. Examination of skin biopsies revealed C. neoformans as the causative organism. In both patients the cellulitis was the presenting clinical manifestation of disseminated cryptococcosis. Therapy with antifungal agents was successful. Disseminated cryptococcal disease occurs mainly in immunocompromised patients. When left untreated, it nearly always has a fatal course. early diagnosis and appropriate therapy are therefore essential.- - - - - - - - - - ranking = 5keywords = cryptococcosis (Clic here for more details about this article) |
9/12. Cutaneous cryptococcosis mimicking bacterial cellulitis in a liver transplant recipient: case report and review in solid organ transplant recipients.Cutaneous cryptococcosis is an uncommon manifestation of disseminated cryptococcal disease. We report a liver transplant recipient presenting with onset over 3 days of progressive pain and swelling of the lower extremity and foot with erythema and heat. Cryptococcal cellulitis was documented, but in retrospect the clinical presentation was indistinguishable in presentation and appearance from acute bacterial cellulitis. The patient also proved to have concomitant cryptococcal septic arthritis; the presence of cryptococcal antigen in the synovial fluid allowed a rapid and definitive diagnosis. Subsequently, cultures of skin, synovial fluid, and blood were all positive for cryptococci. Cryptococcus should be considered in the differential diagnosis of bacterial cellulitis in a liver transplant recipient not responding to antibacterial therapy.- - - - - - - - - - ranking = 5keywords = cryptococcosis (Clic here for more details about this article) |
10/12. Cutaneous cryptococcosis in corticosteroid-treated patients without AIDS.Two corticosteroid-treated patients with cutaneous cryptococcal infection are described. One patient had pustulous lesions on the back of his left hand and cellulitis of his left forearm, the other patient had ulcerous lesions of the right forearm and cellulitis of the right lower leg. In both cases diagnosis was suggested by histopathological examination of a biopsy and confirmed by culture. One patient may have had disseminated cryptococcal disease as suggested by a positive cryptococcal capsular antigen test, the other had no evidence of dissemination. Treatment consisted of oral fluconazole for six weeks. One patient died of an unrelated cause after four weeks treatment. Secondary antifungal prophylaxis was not given. Cutaneous cryptococcal infections are described in AIDS patients, but only seldom observed in other immunocompromised patients. Early recognition of the cutaneous lesions is important, as they can be the first sign of disseminated cryptococcosis. Untreated, the mortality of this disease is high. Therapy consists of amphotericin b with or without flucytosine. fluconazole may be valuable alternative. The optimal treatment regimen and duration are not defined yet. Contrary to AIDS patients with cryptococcal infection, who need life-long secondary antifungal prophylaxis in order to prevent relapses, suppressive treatment is not indicated for immunocompromised non-AIDS patients.- - - - - - - - - - ranking = 5keywords = cryptococcosis (Clic here for more details about this article) |
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