Disseminated Cryptococcosis Presenting as Cellulitis Diagnosed by Laser Capture Microdissection: A Case Report and Literature Review
Disseminated cryptococcosis primarily affects immunosuppressed patients and has a poor outcome if diagnosis and treatment are delayed. Skin lesions are rarely manifest causing misdiagnosis. We present a case of cryptococcal cellulitis with severe pain in a kidney transplant recipient on long-term im...
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| Veröffentlicht in: | Mycopathologia (1975) 2021-06, Vol.186 (3), p.423-433 |
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| creator | Song, Yinggai Liu, Xiao de Hoog, G. Sybren Li, Ruoyu |
| description | Disseminated cryptococcosis primarily affects immunosuppressed patients and has a poor outcome if diagnosis and treatment are delayed. Skin lesions are rarely manifest causing misdiagnosis. We present a case of cryptococcal cellulitis with severe pain in a kidney transplant recipient on long-term immunosuppressive therapy. Multiple organs were involved, and there was cutaneous dissemination of the lesions. Histopathology revealed abundant yeast-like cells with wide capsular halos in subcutaneous tissue, suggesting
Cryptococcus
spp. infection. Laser capture microdissection (LCM)-PCR on skin biopsies confirmed
Cryptococcus neoformans
var.
grubii
. A literature review of 17 cases of disseminated cryptococcosis with cutaneous cellulitis or panniculitis in HIV-negative individuals found that over half the patients (52.9%, 9/17) had a history of glucocorticoid therapy, and that the most common site was the legs (76.5%, 13/17).
C. neoformans
was the main pathogenic species, accounting for 88.2% (15/17) of cases. Fungal cellulitis should be included in the differential diagnosis of cellulitis that fails to respond to antimicrobial therapy in HIV-negative immunosuppressed individuals. Non-culture-based molecular techniques aid in rapid pathogen identification in histologically positive, unculturable specimens. |
| doi_str_mv | 10.1007/s11046-021-00543-3 |
| format | Article |
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Cryptococcus
spp. infection. Laser capture microdissection (LCM)-PCR on skin biopsies confirmed
Cryptococcus neoformans
var.
grubii
. A literature review of 17 cases of disseminated cryptococcosis with cutaneous cellulitis or panniculitis in HIV-negative individuals found that over half the patients (52.9%, 9/17) had a history of glucocorticoid therapy, and that the most common site was the legs (76.5%, 13/17).
C. neoformans
was the main pathogenic species, accounting for 88.2% (15/17) of cases. Fungal cellulitis should be included in the differential diagnosis of cellulitis that fails to respond to antimicrobial therapy in HIV-negative immunosuppressed individuals. Non-culture-based molecular techniques aid in rapid pathogen identification in histologically positive, unculturable specimens.</description><identifier>ISSN: 0301-486X</identifier><identifier>EISSN: 1573-0832</identifier><identifier>DOI: 10.1007/s11046-021-00543-3</identifier><identifier>PMID: 33813690</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Antifungal agents ; Biomedical and Life Sciences ; Case reports ; Cell culture ; Cellulitis ; Cryptococcal infections ; Cryptococcosis ; Cryptococcus neoformans ; Diagnosis ; Differential diagnosis ; Eukaryotic Microbiology ; Fungal infections ; Glucocorticoids ; Health aspects ; Histochemistry ; HIV ; Human immunodeficiency virus ; Immunosuppressive agents ; Immunotherapy ; Kidney transplantation ; Kidneys ; Life Sciences ; Literature reviews ; Medical Microbiology ; Microbial Ecology ; Microbiology ; Organ transplant recipients ; Original Article ; Plant Sciences ; Skin ; Skin diseases ; Skin lesions ; Transplantation</subject><ispartof>Mycopathologia (1975), 2021-06, Vol.186 (3), p.423-433</ispartof><rights>The Author(s), under exclusive licence to Springer Nature B.V. 2021</rights><rights>COPYRIGHT 2021 Springer</rights><rights>The Author(s), under exclusive licence to Springer Nature B.V. 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-aa363773a714372088bdeb761c44ca8127ae5666c4a4d7dcc5a2ae23ea1dcf223</citedby><cites>FETCH-LOGICAL-c476t-aa363773a714372088bdeb761c44ca8127ae5666c4a4d7dcc5a2ae23ea1dcf223</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11046-021-00543-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11046-021-00543-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33813690$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Song, Yinggai</creatorcontrib><creatorcontrib>Liu, Xiao</creatorcontrib><creatorcontrib>de Hoog, G. Sybren</creatorcontrib><creatorcontrib>Li, Ruoyu</creatorcontrib><title>Disseminated Cryptococcosis Presenting as Cellulitis Diagnosed by Laser Capture Microdissection: A Case Report and Literature Review</title><title>Mycopathologia (1975)</title><addtitle>Mycopathologia</addtitle><addtitle>Mycopathologia</addtitle><description>Disseminated cryptococcosis primarily affects immunosuppressed patients and has a poor outcome if diagnosis and treatment are delayed. Skin lesions are rarely manifest causing misdiagnosis. We present a case of cryptococcal cellulitis with severe pain in a kidney transplant recipient on long-term immunosuppressive therapy. Multiple organs were involved, and there was cutaneous dissemination of the lesions. Histopathology revealed abundant yeast-like cells with wide capsular halos in subcutaneous tissue, suggesting
Cryptococcus
spp. infection. Laser capture microdissection (LCM)-PCR on skin biopsies confirmed
Cryptococcus neoformans
var.
grubii
. A literature review of 17 cases of disseminated cryptococcosis with cutaneous cellulitis or panniculitis in HIV-negative individuals found that over half the patients (52.9%, 9/17) had a history of glucocorticoid therapy, and that the most common site was the legs (76.5%, 13/17).
C. neoformans
was the main pathogenic species, accounting for 88.2% (15/17) of cases. Fungal cellulitis should be included in the differential diagnosis of cellulitis that fails to respond to antimicrobial therapy in HIV-negative immunosuppressed individuals. Non-culture-based molecular techniques aid in rapid pathogen identification in histologically positive, unculturable specimens.</description><subject>Antifungal agents</subject><subject>Biomedical and Life Sciences</subject><subject>Case reports</subject><subject>Cell culture</subject><subject>Cellulitis</subject><subject>Cryptococcal infections</subject><subject>Cryptococcosis</subject><subject>Cryptococcus neoformans</subject><subject>Diagnosis</subject><subject>Differential diagnosis</subject><subject>Eukaryotic Microbiology</subject><subject>Fungal infections</subject><subject>Glucocorticoids</subject><subject>Health aspects</subject><subject>Histochemistry</subject><subject>HIV</subject><subject>Human immunodeficiency virus</subject><subject>Immunosuppressive agents</subject><subject>Immunotherapy</subject><subject>Kidney transplantation</subject><subject>Kidneys</subject><subject>Life Sciences</subject><subject>Literature reviews</subject><subject>Medical Microbiology</subject><subject>Microbial Ecology</subject><subject>Microbiology</subject><subject>Organ transplant recipients</subject><subject>Original Article</subject><subject>Plant Sciences</subject><subject>Skin</subject><subject>Skin diseases</subject><subject>Skin lesions</subject><subject>Transplantation</subject><issn>0301-486X</issn><issn>1573-0832</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9ks2LUzEUxR-iOHX0H3AhATe6eGO-mry6Kx0_BipKVXAXbvNuS4Y2qbl5avf-4abT0WFEJItAzu8cci-naR4LfiY4ty9ICK5Ny6VoOR9r1ao7zUiMrWp5p-TdZsQVF63uzJeT5gHRJefVJuz95kSpTigz4aPm53kgwm2IULBns7zfleST94kCsQ8ZCWMJcc2A2Aw3m2ETShXOA6xjoupY7tkcCDObwa4MGdm74HPqD6G-hBRfsmmVCNkCdykXBrFn81AwwxW9wG8Bvz9s7q1gQ_jo-j5tPr9-9Wn2tp2_f3Mxm85br60pLYAyyloFVmhlJe-6ZY9La4TX2kMnpAUcG2O8Bt3b3vsxSECpEETvV1Kq0-bZMXeX09cBqbhtIF_HgohpICfHNXMia2JFn_6FXqYhx_q7Smkr7ER1-oZawwZdiKtUMvhDqJsaU6nOTFSlzv5B1dPXxfsUcRXq-y3D81uGyhT8UdYwELmLj4vbrDyyde1EGVdul8MW8t4J7g41cceauFoTd1UTdzA9uZ5uWG6x_2P53YsKqCNAVYprzDfj_yf2F-Ulxvg</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Song, Yinggai</creator><creator>Liu, Xiao</creator><creator>de Hoog, G. Sybren</creator><creator>Li, Ruoyu</creator><general>Springer Netherlands</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>ISR</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88A</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20210601</creationdate><title>Disseminated Cryptococcosis Presenting as Cellulitis Diagnosed by Laser Capture Microdissection: A Case Report and Literature Review</title><author>Song, Yinggai ; Liu, Xiao ; de Hoog, G. Sybren ; Li, Ruoyu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-aa363773a714372088bdeb761c44ca8127ae5666c4a4d7dcc5a2ae23ea1dcf223</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Antifungal agents</topic><topic>Biomedical and Life Sciences</topic><topic>Case reports</topic><topic>Cell culture</topic><topic>Cellulitis</topic><topic>Cryptococcal infections</topic><topic>Cryptococcosis</topic><topic>Cryptococcus neoformans</topic><topic>Diagnosis</topic><topic>Differential diagnosis</topic><topic>Eukaryotic Microbiology</topic><topic>Fungal infections</topic><topic>Glucocorticoids</topic><topic>Health aspects</topic><topic>Histochemistry</topic><topic>HIV</topic><topic>Human immunodeficiency virus</topic><topic>Immunosuppressive agents</topic><topic>Immunotherapy</topic><topic>Kidney transplantation</topic><topic>Kidneys</topic><topic>Life Sciences</topic><topic>Literature reviews</topic><topic>Medical Microbiology</topic><topic>Microbial Ecology</topic><topic>Microbiology</topic><topic>Organ transplant recipients</topic><topic>Original Article</topic><topic>Plant Sciences</topic><topic>Skin</topic><topic>Skin diseases</topic><topic>Skin lesions</topic><topic>Transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Song, Yinggai</creatorcontrib><creatorcontrib>Liu, Xiao</creatorcontrib><creatorcontrib>de Hoog, G. 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Sybren</au><au>Li, Ruoyu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disseminated Cryptococcosis Presenting as Cellulitis Diagnosed by Laser Capture Microdissection: A Case Report and Literature Review</atitle><jtitle>Mycopathologia (1975)</jtitle><stitle>Mycopathologia</stitle><addtitle>Mycopathologia</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>186</volume><issue>3</issue><spage>423</spage><epage>433</epage><pages>423-433</pages><issn>0301-486X</issn><eissn>1573-0832</eissn><abstract>Disseminated cryptococcosis primarily affects immunosuppressed patients and has a poor outcome if diagnosis and treatment are delayed. Skin lesions are rarely manifest causing misdiagnosis. We present a case of cryptococcal cellulitis with severe pain in a kidney transplant recipient on long-term immunosuppressive therapy. Multiple organs were involved, and there was cutaneous dissemination of the lesions. Histopathology revealed abundant yeast-like cells with wide capsular halos in subcutaneous tissue, suggesting
Cryptococcus
spp. infection. Laser capture microdissection (LCM)-PCR on skin biopsies confirmed
Cryptococcus neoformans
var.
grubii
. A literature review of 17 cases of disseminated cryptococcosis with cutaneous cellulitis or panniculitis in HIV-negative individuals found that over half the patients (52.9%, 9/17) had a history of glucocorticoid therapy, and that the most common site was the legs (76.5%, 13/17).
C. neoformans
was the main pathogenic species, accounting for 88.2% (15/17) of cases. Fungal cellulitis should be included in the differential diagnosis of cellulitis that fails to respond to antimicrobial therapy in HIV-negative immunosuppressed individuals. Non-culture-based molecular techniques aid in rapid pathogen identification in histologically positive, unculturable specimens.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>33813690</pmid><doi>10.1007/s11046-021-00543-3</doi><tpages>11</tpages></addata></record> |
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| subjects | Antifungal agents Biomedical and Life Sciences Case reports Cell culture Cellulitis Cryptococcal infections Cryptococcosis Cryptococcus neoformans Diagnosis Differential diagnosis Eukaryotic Microbiology Fungal infections Glucocorticoids Health aspects Histochemistry HIV Human immunodeficiency virus Immunosuppressive agents Immunotherapy Kidney transplantation Kidneys Life Sciences Literature reviews Medical Microbiology Microbial Ecology Microbiology Organ transplant recipients Original Article Plant Sciences Skin Skin diseases Skin lesions Transplantation |
| title | Disseminated Cryptococcosis Presenting as Cellulitis Diagnosed by Laser Capture Microdissection: A Case Report and Literature Review |
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