Muscular-skeletal cryptococcosis in a patient with idiopathic CD4+ lymphopenia.
A healthy 27-year-old woman presented, four months after childbirth, ingravescent pain and claudication of the left lower limb. Magnetic Resonance Imaging of the lumbosacral and iliac regions showed widespread muscular-skeletal lesions. The patient underwent surgery; Cryptococcus neoformans was isolated from surgical samples. Liposomal amphotericin B, fluconazole and itraconazole were administered. Laboratory findings showed lymphocytopenia, with reduction of CD4+ lymphocytes (23 cells per cubic millimeter) in the absence of HIV infection and any other defined immunodeficiency. This is a rare case of muscular-skeletal cryptococcal infection isolated in a subject affected with idiopathic CD4+ lymphocytopenia.
Zanelli
G
G
Istituto di Clinica delle Malattie Infettive, Università di Siena, Siena, Italy. segmalinf@unisi.it
Sansoni
A
A
Ricciardi
B
B
Ciacci
C
C
Cellesi
C
C
D000038:Abscess / Q000382:microbiology / Q000601:surgery; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000166:cytology / Q000276:immunology; D003453:Cryptococcosis / Q000150:complications* / Q000276:immunology / Q000382:microbiology / Q000628:therapy; D003455:Cryptococcus neoformans / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008231:Lymphopenia / Q000150:complications* / Q000276:immunology; D008279:Magnetic Resonance Imaging; D009140:Musculoskeletal Diseases / Q000150:complications* / Q000276:immunology / Q000382:microbiology / Q000628:therapy; D013131:Spine / Q000382:microbiology
D000935:Antifungal Agents