Tuberc Respir Dis.  2008 Dec;65(6):527-531.

A Case of Disseminated Cutaneous Cryptococcosis Accompanied by Pulmonary Tuberculosis

• Choi HJ
• Lee SH
• Lee TH
• Yoo KH
• Lee KY
• Kim SJ

Abstract

Although disseminated cryptococcosis occurs most commonly in immunocompromised patients, particularly those with a human immunodeficiency virus (HIV) infection, it can occur in immune competent persons. There are no case reports of disseminated cutaneous crytpcoccosis associated with pulmonary tuberculosis in Korea. A 71-year-old female presented with fever and multiple cutaneous nodules. She was finally diagnosed with disseminated cutaneous cryptococcosis accompanied by pulmonary tuberculosis, and was treated successfully with anti-tuberculous medication and fluconazole. She had no apparent predisposing conditions for systemic cryptococcosis. We report this case with a review of the relevant literature.

Keyword

Cryptococcosis; Tuberculosis

MeSH Terms

Aged
Cryptococcosis
Female
Fever
Fluconazole
HIV
Humans
Immunocompromised Host
Korea
Tuberculosis
Tuberculosis, Pulmonary
Fluconazole

Figure

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  Figure 1 Ulcerative skin lesions were showed on dorsum of left hand and medial side of left upper arm after first debridement.

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  Figure 2 Initial chest X-ray showed increased interstitial markings on both lungs and consolidation on both lower lung fields.

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  Figure 3 Chest CT on admission showed bilateral small nodules scattered on both lungs (thin arrow) and bilateral pulmonary embolisms (thick arrow).

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  Figure 4 Microabscess with numerous round to oval fungal spores is noted in the dermis and subcutaneous tissue (H&E stain, ×400).

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  Figure 5 Numerous encapsulated fungal spores, morphologically consistent with cryptococcus, are stained by Gomori's methenamine siver stain and show black color (GMS stain, ×1,000).

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  Figure 6 Skin lesions of the patient were completely healed after treatment.

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