Subcutaneous cryptococcosis due to Cryptococcus diffluens in a patient with sporotrichoid lesions case report, features of the case isolate and in vitro antifungal susceptibilities.
Environmental fungi, in particular primary pathogens and Cryptococcus spp. can be responsible for skin lesions mimicking sporotrichosis. In this paper, we report a case of subcutaneous cryptococcosis in an apparently healthy, young male patient due to a non-C. neoformans Cryptococcus species, C. diffluens. The isolate showed in vitro phenotypic switching that may affect virulence and host inflammatory and immune responses, and in vitro resistance to amphotericin B and 5-flucytosin. This species shares several phenotypic traits with C. neoformans, and, therefore, decisive diagnosis should be based on biopsy and culturing results followed by molecular identification.
Kantarcioğlu
A Serda
AS
Cerrahpasa Medical Faculty, Department of Microbiology and Clinical Microbiology, Deep Mycosis Laboratory, Istanbul University, Istanbul,Turkey. s.kantarcioglu@superonline.com
Boekhout
Teun
T
De Hoog
G Sybren
GS
Theelen
Bart
B
Yücel
Ayhan
A
Ekmekci
Tuba R
TR
Fries
Bettina C
BC
Ikeda
Reiko
R
Koslu
Adem
A
Altas
Kemal
K
D000293:Adolescent; D000666:Amphotericin B / Q000494:pharmacology; D000935:Antifungal Agents / Q000494:pharmacology; D001483:Base Sequence; D003453:Cryptococcosis / Q000175:diagnosis / Q000382:microbiology* / Q000473:pathology; D003454:Cryptococcus / Q000166:cytology / Q000187:drug effects* / Q000302:isolation & purification* / Q000502:physiology; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D004275:DNA, Ribosomal / Q000737:chemistry / Q000235:genetics; D021903:DNA, Ribosomal Spacer / Q000737:chemistry / Q000235:genetics; D003937:Diagnosis, Differential; D025141:Drug Resistance, Fungal; D005437:Flucytosine / Q000494:pharmacology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D012339:RNA, Ribosomal, 28S / Q000235:genetics; D017422:Sequence Analysis, DNA; D013174:Sporotrichosis / Q000175:diagnosis
D000935:Antifungal Agents; D004271:DNA, Fungal; D004275:DNA, Ribosomal; D021903:DNA, Ribosomal Spacer; D012339:RNA, Ribosomal, 28S; D000666:Amphotericin B; D005437:Flucytosine