A Case of Primary Cutaneous Cryptococcosis Misdiagnosel as Skin Tuberculosis / 대한의진균학회지

ABSTRACT

Cryptococcosis is an opportunistic yeast infection caused by Cryptococcosis neoformans. The cutaneous manifestations are usually polymorphic and nonspecific. Lesions may appear as subcutaneous swelling, abscesses, tumor-like masses, papules or large ulcers. Therefore, diagnosis of cutaneous cryptococcosis is quite difficult and often delayed. Clinical suspicion is very important in diagnosis. A 47-year-old man presented with a ulcerative nodule on the right side of the neck. Because initial skin biopsy revealed granulomatous lesion, we misdiagnosed his lesion as skin tuberculosis and treated him with anti tuberculosis medication for 6 months. But his symptom was not improved. After second biopsy specimen had showed some spores with narrow neck budding, we confirmed this case as a cryptococcosis and successfully treated with itraconazole (200 mg/day) for 12 weeks.