A Case of Disseminated Cryptococcosis in an Immunocompetent Adult

ABSTRACT

Disseminated cryptococcosis is a systemic infection that occurs most commonly in immunocompromised patients, especially those with human immunodeficiency virus (HIV) infection. Although the attack rate is much higher among immunocompromised patients, cryptococcal disease does occur in persons without any apparent predisposing conditions. A previously healthy 26-year- old man was admitted to the hospital because of persistent fever and cervical lymphadenopathy. Despite empirical antibiotic therapy, he developed cutaneous erythematous papules, generalized lymphadenopathy, miliary pulmonary infiltration, and meningitis successively soon after admission. Biopsy of the skin and the cervical lymph node revealed chronic granuloma with cryptococcal organisms and tissue culture of lymph node confirmed cryptococcal infection. He was treated with intravenous amphotericin B plus flucytosine for 2 weeks, and then with fluconazole for 2 months. After the therapy, there was no evidence of recurrence for 2 years.