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A cryptic diagnosis: disseminated cryptococcal disease presenting as an asymptomatic pulmonary nodule and a skin lesion: a case report.

Abbas A, Sikkel MB, Collins JP, Davies CW, Chen F - Cases J (2008)

Bottom Line: In the immunocompromised host cryptococcus may disseminate resulting in significant mortality and morbidity.We report the case of a 49-year-old homosexual male presenting with an atypical skin lesion associated with an asymptomatic pulmonary nodule.A subsequent diagnosis of disseminated cryptococcosis was made on India ink staining of cerebrospinal fluid.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Respiratory Medicine, Royal Berkshire Hospital NHS Trust, Reading, UK. drausami_abbas@msn.com.

ABSTRACT

Background: Cryptococcosis refers to a spectrum of infections caused by the encapsulated yeast Cryptococcus neoformans. In the immunocompromised host cryptococcus may disseminate resulting in significant mortality and morbidity.

Case presentation: We report the case of a 49-year-old homosexual male presenting with an atypical skin lesion associated with an asymptomatic pulmonary nodule. A subsequent diagnosis of disseminated cryptococcosis was made on India ink staining of cerebrospinal fluid.

Conclusion: A diagnosis of cryptococcosis should be considered in all patients at risk of immunocompromise that present with asymptomatic pulmonary nodules in the presence of extrapulmonary manifestations, as exemplified by the unusual skin ulceration in our case.

No MeSH data available.


Related in: MedlinePlus

Chest radiograph showing shadowing in the right upper zone.
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Figure 2: Chest radiograph showing shadowing in the right upper zone.

Mentions: Initial blood tests showed a mild microcytic anaemia (Hb 11.7 g/dL, MCV 76.0 fL) and lymphopaenia (WBC 2.78 × 109 L-1, Lymphocytes 0.44 × 109 L-1). HIV antibody titres at 3 days were positive. Chest radiograph on admission was abnormal; showing a 3.8 cm area of nodular shadowing in the right upper zone (Fig 2) which prompted computed tomography (CT) imaging of the chest (Fig 3).


A cryptic diagnosis: disseminated cryptococcal disease presenting as an asymptomatic pulmonary nodule and a skin lesion: a case report.

Abbas A, Sikkel MB, Collins JP, Davies CW, Chen F - Cases J (2008)

Chest radiograph showing shadowing in the right upper zone.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2628382&req=5

Figure 2: Chest radiograph showing shadowing in the right upper zone.
Mentions: Initial blood tests showed a mild microcytic anaemia (Hb 11.7 g/dL, MCV 76.0 fL) and lymphopaenia (WBC 2.78 × 109 L-1, Lymphocytes 0.44 × 109 L-1). HIV antibody titres at 3 days were positive. Chest radiograph on admission was abnormal; showing a 3.8 cm area of nodular shadowing in the right upper zone (Fig 2) which prompted computed tomography (CT) imaging of the chest (Fig 3).

Bottom Line: In the immunocompromised host cryptococcus may disseminate resulting in significant mortality and morbidity.We report the case of a 49-year-old homosexual male presenting with an atypical skin lesion associated with an asymptomatic pulmonary nodule.A subsequent diagnosis of disseminated cryptococcosis was made on India ink staining of cerebrospinal fluid.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Respiratory Medicine, Royal Berkshire Hospital NHS Trust, Reading, UK. drausami_abbas@msn.com.

ABSTRACT

Background: Cryptococcosis refers to a spectrum of infections caused by the encapsulated yeast Cryptococcus neoformans. In the immunocompromised host cryptococcus may disseminate resulting in significant mortality and morbidity.

Case presentation: We report the case of a 49-year-old homosexual male presenting with an atypical skin lesion associated with an asymptomatic pulmonary nodule. A subsequent diagnosis of disseminated cryptococcosis was made on India ink staining of cerebrospinal fluid.

Conclusion: A diagnosis of cryptococcosis should be considered in all patients at risk of immunocompromise that present with asymptomatic pulmonary nodules in the presence of extrapulmonary manifestations, as exemplified by the unusual skin ulceration in our case.

No MeSH data available.


Related in: MedlinePlus