Infect Chemother.  2017 Jun;49(2):142-145. 10.3947/ic.2017.49.2.142.

A Case of Disseminated Infection with Skin Manifestation due to Non-neoformans and Non-gattii Cryptococcus in a Patient with Refractory Acute Myeloid Leukemia

Affiliations
  • 1Department of Internal Medicine, National Cancer Center, Goyang, Korea.
  • 2Hematologic Oncology Clinic, National Cancer Center, Goyang, Korea. hseom@ncc.re.kr
  • 3Department of Pathology, National Cancer Center, Goyang, Korea.
  • 4Department of Laboratory Medicine, National Cancer Center, Goyang, Korea.
  • 5Infectious Disease Clinic, National Cancer Center, Goyang, Korea.

Abstract

Cryptococcus spp. other than Cryptococcus neoformans or Cryptococcus gattii were previously considered saprophytes and thought to be non-pathogenic to humans. However, opportunistic infections associated with non-neoformans and non-gattii species, such as Cryptococcus laurentii and Cryptococcus albidus, have increased over the past four decades. We experienced a case of cryptococcosis caused by non-neoformans and non-gattii spp. in a 47-year-old female with refractory acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation. The patient underwent salvage chemotherapy with fluconazole prophylaxis and subsequently developed neutropenic fever with multiple erythematous umbilicated papules. A skin biopsy revealed fungal hyphae and repetitive blood cultures showed yeast microorganisms that were identified later as C. laurentii by Vitek-II®. Skin lesions and fever began to improve with conventional amphotericin B therapy. The treatment regimen was continued for 21 days until the disseminated cryptococcosis was completely controlled.

Keyword

Cryptococcosis; Cryptococcus laurentii; non-neoformans; non-gattii cryptococci

MeSH Terms

Amphotericin B
Biopsy
Cryptococcosis
Cryptococcus gattii
Cryptococcus neoformans
Cryptococcus*
Drug Therapy
Female
Fever
Fluconazole
Hematopoietic Stem Cell Transplantation
Humans
Hyphae
Leukemia, Myeloid, Acute*
Middle Aged
Opportunistic Infections
Skin Manifestations*
Skin*
Yeasts
Amphotericin B
Fluconazole
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