SKELETAL CRYPTOCOCCOSIS IN AN IMMUNOCOMPETENT PERSON: A CASE REPORT & LITERATURE REVIEW

Authors

  • Ghulam Rabbani Anwar Ayub Medical College Pakistan
  • Danial Tahir Ayub Medical College
  • Sidra Humayun Rehman Medical College Pakistan
  • Muhammad Irfan Ayub Medical College Pakistan

Keywords:

Skeletel, Cryptococcosis, Immunocompetent, Case Report, Literature Review

Abstract

Cryptococcus neoformans and Cryptococcus gattii can cause a deadly opportunistic infection, called cryptococcosis. Symptomatic cryptococcosis is commonly seen in immunocompromised patients. Cryptococcus is a facultative intracellular fungus, which can exist freely in the environment or inside the soil. Similarly, it can be found inside the phagocytes or freely in body tissues and fluids. The most common sites of infection include the brain and the lungs. It also has a propensity to cause disseminated infections especially in the immunocompromised host, such as HIV patients. Symptomatic infections in people with a competent immune system are rare, but cases of localized cryptococcosis have been reported in the literature. Disseminated and skeletal cryptococcosis are the rarest forms of infection in an immunocompetent host. Here we present a case of a 65-year-old man with a prolonged fever and non-specific symptoms who was diagnosed with skeletal cryptococcosis. He was apparently immunocompetent with negative HIV and other virological markers on repeat testing. His condition was diagnosed too late due to the extremely low probability of cryptococcal infection in an immunocompetent person. A physician must have a high degree of clinical suspicion to catch the disease early in such patients. Prompt initiation of treatment early in the disease course is essential for survival.

References

Akaihe CL, Nweze El.: Epidemiology of Cryptococcus and cryptococcosis in Western Africa. Mycoses. 2021, 64:4-17. 10.1111/myc.13188

Adzic-Vukicevic T, Cevik M, Poluga J, Micic J, Rubino S, Paglietti B, Barac A.: An exceptional case report of disseminated cryptococcosis in a hitherto immunocompetent patient. Revista do Instituto de Medicina Tropical de São Paulo. 2020, 62:10.1590/S1678-9946202062003

Deus G, Gómez-Zorrilla S, Echeverria-Esnal D, et al.: Osteoarticular Cryptococcosis Successfully Treated with High-Dose Liposomal Amphotericin B Followed by Oral Fluconazole. Infection and Drug Resistance. 2021, 14:719. 10.2147/IDR.S294299

Mada PK, Jamil RT, Alam MU.: Cryptococcus. [Updated 2021 Jun 15]. StatPearls [Internet]. StatPearls Publishing, Treasure Island (FL); 2021.

May RC, Stone NR, Wiesner DL, Bicanic T, Nielsen K. : Cryptococcus: from environmental saprophyte to global pathogen. Nature Reviews Microbiology. 2016, 14(2):106-17. 10.1038/nrmicro.2015.6

Cryptococcus neoformans infection outside the central nervous system. (2019). Accessed: 2021: https://www.uptodate.com/contents/cryptococcus-neoformans-infection-outside-the-central-nervous-system?search=dissemi.

Qu J, Zhang X, Lu Y.: Clinical analysis in immunocompetent and immunocompromised patients with pulmonary cryptococcosis in western China. Sci Rep. 2020, 10:10.1038/s41598-020-66094-7

Zhou HX, Lu L, Chu T, et al.: Skeletal cryptococcosis from 1977 to 2013. Frontiers in microbiology. 2015, 14:740. 10.3389%2Ffmicb.2014.00740

Ramkillawan Y, Dawood H, Ferreira N.: Isolated cryptococcal osteomyelitis in an immune-competent host: a case report. International Journal of Infectious Diseases. 2013, 17(12):e1229-31. 10.1016/j.ijid.2013.04.013

Qadir I, Ali F, Malik U Z, umer m.: Isolated cryptococcal osteomyelitis in an immunocompetent patient. J Infect Dev Ctries. 2011, 14(5):669-673.

Published

2021-08-14

How to Cite

Anwar, G. R., Tahir, D., Humayun, S., & Irfan, M. (2021). SKELETAL CRYPTOCOCCOSIS IN AN IMMUNOCOMPETENT PERSON: A CASE REPORT & LITERATURE REVIEW . THE STETHO, 2(8), 104-08. Retrieved from http://thestetho.com/index.php/ts/article/view/40