1.A soft tissue lesion on the scalp as a peculiar source of disseminated cryptococcosis
Ding C.H. ; Wahab A.A. ; Abd Rahman N.A ; Zaihan S. ; Abd Shukor N. ; Periyasamy P. ; Cheong X.K. ; Mokhtar M.N.
Tropical Biomedicine 2026;43(No. 2):159-162
Cryptococcosis is a potentially fatal invasive fungal infection with considerable health challenges. A
seemingly immunocompetent middle-aged man with frequent exposure to pigeons and bird excreta
presented with headaches, fever, gait instability and diplopia. Two years prior to his presentation, he
sustained a blunt head trauma which resulted in sporadic headaches. On examination, a hard scalp
nodule measuring approximately 3 x 3 cm was palpable on the topmost part of his head. Cryptococcus
neoformans was cultured from his cerebrospinal fluid, blood and the biopsied scalp nodule. A diagnosis
of disseminated cryptococcosis was made, with the scalp lesion being designated as the primary source
of the infection. Following a protracted course of antifungal therapy lasting 10 weeks, the patient
was asymptomatic without any neurological deficits when reviewed in the clinic at two months postdischarge.
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