Lauerma A I, Jeskanen L, Rantanen T, Stubb S, Kariniemi A L
Department of Dermatology, Helsinki University Central Hospital, Helsinki, Finland.
Dermatology. 1999;199(2):180-2. doi: 10.1159/000018234.
Cryptococcosis is an opportunistic infection caused by a fungus, Cryptococcus neoformans. It is usually seen in immunocompromised patients with AIDS, leukaemia, lymphoma, sarcoidosis or immunosuppressive treatments. We describe a patient who was treated with systemic glucocorticosteroids for 4 years because of lung sarcoidosis. During the last year of treatment, a papular eruption developed which later became ulcerative. In a histopathological examination of a skin biopsy, there was granulomatous inflammation, and the disease was treated as sarcoidosis without success. After 1 year's unsuccessful treatment, another skin biopsy and skin fungal culture revealed C. neoformans. Cryptococcal antigen was found in blood and cerebrospinal fluid, too. The patient was successfully treated first with an amphotericin-B-flucytosine combination and later with fluconazole.
隐球菌病是一种由新型隐球菌真菌引起的机会性感染。它通常见于患有艾滋病、白血病、淋巴瘤、结节病或接受免疫抑制治疗的免疫功能低下患者。我们描述了一名因肺结节病接受全身性糖皮质激素治疗4年的患者。在治疗的最后一年，出现了丘疹性皮疹，后来发展为溃疡性。在皮肤活检的组织病理学检查中，发现有肉芽肿性炎症，该疾病被当作结节病治疗但未成功。经过1年的无效治疗后，再次进行皮肤活检和皮肤真菌培养发现了新型隐球菌。血液和脑脊液中也发现了隐球菌抗原。该患者首先用两性霉素B-氟胞嘧啶联合治疗，后来用氟康唑成功治愈。
