Cryptococcal panniculitis in an immunocompromised patient: a case report and review of the literature

Abstract

Cryptococcus neoformans is a dimorphic fungus known to cause disease predominately in immuno-compromised patients. It is not uncommon for cryptococcal disease to manifest within the cutaneous tissues of these patients, and it can have drastically varied presentations, from ulcerated nodules to a more subtle cellulitis. We present a patient who underwent a cardiac transplant and developed a fever and mildly erythematous, indurated plaques on his legs and flank several years later. Skin biopsy revealed cryptococcal panniculitis and C neoformans subsequently grew from both the biopsy culture and the cerebrospinal fluid (CSF). This case report highlights the varied and subtle presentations of cutaneous cryptococcosis in immunocompromised patients and encourages a high index of suspicion for this potentially fatal disease in the setting of immunosuppression.