Cryptococcal meningitis with an antecedent cutaneous Cryptococcal lesion.
Cutaneous cryptococcosis, caused by an encapsulated yeast, Cryptococcus neoformans, is generally associated with concomitant systemic infection. Here we report a case of primary cutaneous cryptococcosis with spread to central nervous system in an HIV seronegative young boy. In the present case, a 17-year-old boy who was suffering from a non-healing ulcer on his right great toe for 5 months, presented with the signs and symptoms of meningitis. Cryptococcus neoformans var. gattii was isolated from the CSF of the patient. Amphotericin B administration produced recovery from the meningitis as well as from the ulcer. This case study suggests that primary cutaneous cryptococcosis can be diagnosed provisionally by a simple Gram stained smear and India ink examination in order to avoid occurrence of disseminated cryptococcosis, including meningial involvement, which may have a fatal outcome.
Tilak
Ragini
R
Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi. raginijain29@rediffmail.com
Prakash
Pradyot
P
Nigam
Chaitanya
C
Tilak
Vijai
V
Gambhir
I S
IS
Gulati
A K
AK
D000293:Adolescent; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002244:Carbon; D004396:Coloring Agents; D003453:Cryptococcosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D056285:Cryptococcus gattii / Q000302:isolation & purification*; D003881:Dermatomycoses / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D015725:Fluconazole / Q000627:therapeutic use; D016523:Foot Ulcer / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D016469:Fungemia / Q000209:etiology; D005840:Gentian Violet; D018023:HIV Seronegativity; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000188:drug therapy / Q000209:etiology*; D010619:Phenazines; D013194:Staining and Labeling; D014034:Toes / Q000382:microbiology*
D000935:Antifungal Agents; D004396:Coloring Agents; C035863:Gram's stain; D010619:Phenazines; C028433:chinese ink; D002244:Carbon; D000666:Amphotericin B; D015725:Fluconazole; D005840:Gentian Violet