title: Cryptococcal parotid involvement: an uncommon localization of Cryptococcus neoformans.
abstract: We describe a cryptococcal infection localized in the parotid gland of an otherwise healthy 72-year-old woman. The patient presented with a painful, approximately 4.5 cm diameter mass in the anterior region of her right ear. Her symptoms were mild and uncharacteristic. The patient had previously fallen on her face in her garden, causing the loss and breakage of her dentures. Since the soil of the garden contained chicken droppings, it is quite likely that the oral prothesis became contaminated on contacting the soil. The fungus probably entered the parotid gland through the traumatization of the posterior lateral wall of her oral cavity by her broken denture. Numerous intra- and extracellular cryptococcal yeast cells were observed in both histopathological and mycological slide preparations. The yeastlike fungus was recovered in cultures inoculated with tissue collected through three biopsies of her parotid region. The isolates were identified as Cryptococcus neoformans by classical mycology methods and found to be susceptible, in vitro, to fluconazole, amphotericin B and flucytosine. Fluconazole treatment (400 mg/d, for 6 months) was started and the patients facial swelling resolved and the pain significantly reduced within 5 weeks of the initiation of treatment. While fungal infection of the parotid gland have been reported, to our knowledge, this is the first description of a non-disseminated primary parotid infection due to C. neoformans.
authors.affiliation: Department of Microbiology and Clinical Microbiology, Cerrahpasa Medical Faculty, Istanbul, Turkey. s.kantarcioglu@superonline.com
authors.forename: A Serda
authors.initials: AS
authors.lastname: Kantarcioğlu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gulenc
authors.forename: Ayhan
authors.initials: A
authors.lastname: Yücel
authors.forename: Nuray
authors.initials: N
authors.lastname: Uzun
authors.forename: Tugba
authors.initials: T
authors.lastname: Taskin
authors.forename: Damlanur
authors.initials: D
authors.lastname: Sakiz
authors.forename: Kemal
authors.initials: K
authors.lastname: Altas
mesh_terms: D000368:Aged; D003453:Cryptococcosis / Q000188:drug therapy / Q000209:etiology*; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D005260:Female; D006801:Humans; D010305:Parotid Diseases / Q000188:drug therapy / Q000209:etiology*