Primary Cutaneous Cryptococcosis in a Patient with Iatrogenic Cushing's Syndrome: A Case Report and Review of the Literature.
10.5145/KJCM.2012.15.2.70
- Author:
Young Jin KO
1
;
Mi Hyun HONG
;
Chul Min PARK
;
Hee Won MOON
;
Mina HUR
;
Yeo Min YUN
Author Information
1. Department of Laboratory Medicine, Konkuk University School of Medicine and Medical Center, Seoul, Korea. hannasis@kuh.ac.kr
- Publication Type:Case Report
- Keywords:
Cryptococcus neoformans;
Cushing's syndrome;
Primary cutaneous cryptococcosis
- MeSH:
Adrenal Cortex Hormones;
Aged;
Anti-Bacterial Agents;
Cellulitis;
Cicatrix;
Cryptococcosis;
Cryptococcus neoformans;
Cushing Syndrome;
Female;
Fluconazole;
Forearm;
Fungi;
Humans;
Immunocompromised Host;
Skin;
Ulcer
- From:Korean Journal of Clinical Microbiology
2012;15(2):70-73
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Cryptococcus neoformans (C. neoformans) is a ubiquitous yeast-like fungus that has been a common opportunistic human pathogen, especially in immunocompromised patients. Although skin lesions due to C. neoformans are found in 10-15% of patients with systemic cryptococcosis, primary cutaneous cryptococcosis without systemic infection is rare and now considered a distinct clinical entity. We report a case of primary cutaneous cryptococcosis in a patient with iatrogenic Cushing's syndrome. A 73-year-old woman presented with pain and discharge from lesions on her left forearm. The patient had been treated with oral corticosteroids for 20 years, and as a result had developed iatrogenic Cushing's syndrome. A skin fragment of the ulcer was cultured, and the encapsulated fungus were isolated and identified as C. neoformans using a Vitek2 system (Vitek2 ID-YST, bio Merieux, France) and API 20C (bioMerieux). Concurrent blood and urine cultures were negative for growth. At first, she was treated with antibiotics due to suspicion of cellulitis. After surgical resection and treatment with systemic and oral fluconazole, her wound was improved with scar. Primary cutaneous cryptococcosis should be considered when skin lesions are not responsive to antibiotics and accurate identification is important for proper treatment.
