Criptococosis vertebral: comunicación de un caso y revisión bibliográfica / Vertebral cryptococosis: case report and literature review

Resumen La criptococosis es una micosis sistémica producida por un hongo levaduriforme encapsulado denominado Cryptococcus neoformans. Es una enfermedad universal, que ocurre con mayor frecuencia en pacientes inmunocomprometidos, manifestándose principalmente como una enfermedad diseminada con compromiso meníngeo o pulmonar. Sin embargo, la osteomielitis ocurre solo en 5-10% de los casos, siendo el compromiso vertebral el más frecuente. Presentamos un caso de criptococosis vertebral aislada y una búsqueda bibliográfica sobre el tema. Se recomienda realizar una terapia antifúngica de inducción intravenosa y continuar con una fase de consolidación, vía oral, de duración variable. La indicación quirúrgica se considera en lesiones que comprometen la estabilidad vertebral y aquellas que presentan un compromiso neurológico, producen deformidad y para reducir el inóculo infeccioso.

Cryptococcosis is an infectious disease caused by a ubiquitous encapsulated yeast called Cryptococcus neoformans, it is usually associated with immunosuppressed patients. Osteomyelitis occurs in 5-10%, the spine involvement is one of the most reported. The purpose of this work is to present a case of isolated vertebral cryptococcosis and detail the results of a literature review. The treatment protocol is not yet established but it is recommended to start with aggressive intravenous therapy and continue with a suppressive treatment orally during a variable time. Surgical indication is considered in lesions that affect the spinal stability, deformity or neurological compromise and for local infectious control.

Solitary Kaposi's Sarcoma of the Lower Lid in an HIV-Negative Patient

PURPOSE: To report a case of solitary Kaposi's sarcoma (KS) of eyelid in an HIV-negative patient, which has not yet been reported in domestics. CASE SUMMARY: A 76-year-old woman was seen at our clinic with a purplish nodular mass on her left lower lid that had grown up for 4 months prior. There were no abnormal findings in the body except eyelid. In the routine laboratory examinations, the result of HIV test was negative. The lesion was completely excised and the eyelid was reconstructed by semicircular rotational flap procedure. The histopathologic examination showed spindle cells of mild atypism, intermixed with slit-like vascular spaces and red blood cell extravastaion. These findings coincided with KS and polymerase chain reaction was positive for human herpes virus-8. During 10 months follow up, there was no evidence of tumor recurrence and systemic abnormalities. CONCLUSIONS: We experienced that Kaposi's sarcoma can occur solitarily in the eyelid of HIV-negative patient and favorable prognosis can be obtained by only surgical resection.