SKELETAL CRYPTOCOCCOSIS IN AN IMMUNOCOMPETENT PERSON: A 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.