title: Disseminated cryptococcosis with adrenal and lung involvement in an immunocompetent patient.
abstract: Disseminated cryptococcosis usually occurs in immunocompromised patients. Occasionally, it affects immunocompetent persons and mimics tuberculosis in clinical presentation and radiological findings. Usually, it affects lungs and central nervous system. Rarely, it may affect adrenal glands. We present a case of 65-year-old gentleman with prolonged pyrexia. Computed Tomography (CT) scan of chest and abdomen showed miliary pattern in the chest with bilateral adrenal masses. On the basis of clinical and radiological findings, the case was initially diagnosed as disseminated tuberculosis and anti tubercular treatment was started. Subsequently, on histopathological examination, the diagnosis was confirmed as disseminated cryptococcosis. Even in a country with high prevalence of tuberculosis, other causes of miliary mottling should be considered and histopathological examination should be sought.
authors.affiliation: Assistant Professor, Department of Medicine, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Piyush
authors.initials: P
authors.lastname: Ranjan
authors.affiliation: Assistant Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Manisha
authors.initials: M
authors.lastname: Jana
authors.affiliation: Junior Resident, Department of Medicine, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Shanmugam
authors.initials: S
authors.lastname: Krishnan
authors.affiliation: Senior Resident, Department of Pathology, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Devajit
authors.initials: D
authors.lastname: Nath
authors.affiliation: Professor, Department of Medicine, All India Institute of Medical Sciences , New Delhi, India .
authors.forename: Rita
authors.initials: R
authors.lastname: Sood
keywords: Adrenal Tuberculosis; Adrenal cryptococcosis; Disseminated tuberculosis; Empirical ATT; Immunocompetent