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免疫功能正常的农民播散性隐球菌病:一例罕见病例报告。

Disseminated cryptococcosis in an immunocompetent farmer: A rare case report.

作者信息

Gaikwad Sunil, Pujari Monika, Joshi Harsh, Kulkarni Shubhada, Patel Divya, Pujari Sanjay

机构信息

Institute of Infectious Diseases, Pune, India.

Poona Hospital and Research Centre, Pune, India.

出版信息

IDCases. 2025 May 5;40:e02241. doi: 10.1016/j.idcr.2025.e02241. eCollection 2025.

Abstract

Cryptococcosis is an opportunistic fungal infection commonly occurring amongst immunocompromised individuals. However, in rare cases it can affect immunocompetent individuals particularly those with exposure to fungal reservoirs in environment. We report a 32-year-old immunocompetent male farmer who was diagnosed with disseminated cryptococcosis. He initially presented with prolonged cough, exertional dyspnoea and weight loss and later developed nodulo-ulcerative skin lesion and central nervous system cryptococcomas. The diagnosis was confirmed by histopathology and cryptococcal antigen testing. He was treated with liposomal amphotericin B and flucytosine, followed by maintenance fluconazole therapy. This case-report highlights the importance of keeping a high index of suspicion for disseminated cryptococcosis even in immunocompetent individuals.

摘要

隐球菌病是一种机会性真菌感染,常见于免疫功能低下的个体。然而,在罕见情况下,它可影响免疫功能正常的个体,特别是那些接触环境中真菌储存库的人。我们报告一例32岁免疫功能正常的男性农民,他被诊断为播散性隐球菌病。他最初表现为长期咳嗽、劳力性呼吸困难和体重减轻,后来出现结节溃疡性皮肤病变和中枢神经系统隐球菌瘤。组织病理学和隐球菌抗原检测确诊了该诊断。他接受了脂质体两性霉素B和氟胞嘧啶治疗,随后接受氟康唑维持治疗。本病例报告强调了即使在免疫功能正常的个体中,对播散性隐球菌病保持高度怀疑指数的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e5e/12136831/6a8679b4bb90/gr1.jpg

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