Abuav Rachel, McGirt Laura Y, Kazin Rebecca A
Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Cutis. 2010 Jun;85(6):303-6.
Cryptococcus neoformans is a dimorphic fungus known to cause disease predominately in immuno-compromised patients. It is not uncommon for cryptococcal disease to manifest within the cutaneous tissues of these patients, and it can have drastically varied presentations, from ulcerated nodules to a more subtle cellulitis. We present a patient who underwent a cardiac transplant and developed a fever and mildly erythematous, indurated plaques on his legs and flank several years later. Skin biopsy revealed cryptococcal panniculitis and C neoformans subsequently grew from both the biopsy culture and the cerebrospinal fluid (CSF). This case report highlights the varied and subtle presentations of cutaneous cryptococcosis in immunocompromised patients and encourages a high index of suspicion for this potentially fatal disease in the setting of immunosuppression.
新型隐球菌是一种双相真菌，主要在免疫功能低下的患者中引发疾病。隐球菌病在这些患者的皮肤组织中表现出来并不罕见，其表现形式差异极大，从溃疡结节到更为隐匿的蜂窝织炎都有。我们报告了一名接受心脏移植的患者，数年后其腿部和侧腹出现发热以及轻度红斑、硬结斑块。皮肤活检显示为隐球菌性脂膜炎，随后活检培养物和脑脊液（CSF）中均培养出新型隐球菌。本病例报告强调了免疫功能低下患者皮肤隐球菌病的多样和隐匿表现，并鼓励在免疫抑制情况下对这种潜在致命疾病保持高度怀疑。
