See Jonathan, Fong Kok Choon Raymond, Shafi Humaira
Department of Infectious Disease, Changi General Hospital, 2 Simei Street 3, Singapore 529889.
Case Rep Infect Dis. 2019 Sep 22;2019:3835701. doi: 10.1155/2019/3835701. eCollection 2019.
We present a case of disseminated cryptococcosis (DC) in a 71-year-old gentleman with systemic lupus erythematosus (SLE) on long-term corticosteroids. He initially presented with right arm cellulitis in a tertiary hospital in Singapore and was subsequently diagnosed with DC involving skin, meninges, blood, and possibly pulmonary involvement. He eventually succumbed to the disease despite prolonged antifungal therapy. Through this case, we wish to highlight an atypical clinical presentation of an uncommon infection and hope to share the importance of considering DC in the differential diagnosis of nonresolving cellulitis among immunocompromised individuals. Mortality and morbidity rates for this condition remain high despite appropriate treatment. Early diagnosis and treatment are crucial for improved outcomes. More research is needed to improve the therapeutic modalities for treatment of DC and to improve the clinical outcomes for this life-threatening condition.
我们报告一例71岁患有系统性红斑狼疮（SLE）且长期使用皮质类固醇的男性播散性隐球菌病（DC）病例。他最初在新加坡一家三级医院因右臂蜂窝织炎就诊，随后被诊断为DC，累及皮肤、脑膜、血液，可能还累及肺部。尽管进行了长时间的抗真菌治疗，他最终还是死于该病。通过这个病例，我们希望强调一种罕见感染的非典型临床表现，并希望分享在免疫功能低下个体的非化脓性蜂窝织炎鉴别诊断中考虑DC的重要性。尽管进行了适当治疗，这种疾病的死亡率和发病率仍然很高。早期诊断和治疗对于改善预后至关重要。需要更多研究来改善DC的治疗方式，并改善这种危及生命疾病的临床结局。
