Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2018 May 21:12:142-148.
doi: 10.1016/j.idcr.2018.05.004. eCollection 2018.

Cryptococcosis as a cause of nephrotic syndrome? A case report and review of the literature

Regev Cohen  1   2 , Frida Babushkin  1 , Maurice Shapiro  3 , Ronen Ben-Ami  4   5 , Talya Finn  1
Affiliations
Case Reports

Cryptococcosis as a cause of nephrotic syndrome? A case report and review of the literature

Regev Cohen et al. IDCases. .

Abstract

We present a case of a 74 years old male with cutaneous cryptococcosis of the right forearm. Cryptococcus neoformans var. neoformans was cultivated from the skin and from the bloodstream. He was diagnosed with nephrotic syndrome (focal segmental glomerulosclerosis) 21 months prior to admission, which was steroid-dependent. He was treated with prednisone and cyclosporine A. Concurrently with his renal disease he was also diagnosed as having disseminated severe tinea mannum, tinea corporis and tinea cruris; onychomycosis, skin eczema and psoriasis. After a prolonged course of anti-fungal therapy, his skin lesions as well as his nephrotic syndrome recovered completely. Follow up after 7 months without any anti-fungal or immunosuppression showed no skin or renal recurrence. We assume that the renal disease was related to the pre-existing cutaneous cryptococcosis, aggravated by immunosuppression, and discuss the close association between cutaneous cryptococcosis and nephrotic syndrome, as well as similar case reports in the literature.

Keywords: Cryptococcemia; Cryptococcus neoformans; Focal segmental glomerulosclerosis; Misdiagnosis; Nephrotic syndrome; Primary cutaneous cryptococcosis; Psoriasis; Tinea.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Cryptococcal cellulitis, right forearm.
Fig. 2
Fig. 2
Abdominal cutaneous lesions diagnosed as psoriasis.
Fig. 3
Fig. 3
Left forearm cutaneous lesion diagnosed as tinea.
Fig. 4
Fig. 4
Reactivation of cryptococcal cutaneous infection, right forearm.
Fig. 5
Fig. 5
New lesion on left forearm.
Fig. 6
Fig. 6
Resolution of skin lesions on the abdomen.
Fig. 7
Fig. 7
– Left forearm lesion after 3 weeks.
Fig. 8
Fig. 8
Left forearm lesion after 11 weeks.
Fig. 9
Fig. 9
Left forearm lesion after 25 weeks.
See this image and copyright information in PMC

References

    1. Neuville S., Dromer F., Morin O., Dupont B., Ronin O., Lortholary O. Primary cutaneous cryptococcosis: a distinct clinical entity. Clin Infect Dis. 2003;36(3):337–347. - PubMed
    1. Savin V.J., McCarthy E.T., Sharma M. Permeability factors in nephrotic syndrome and focal segmental glomerulosclerosis. Kidney Res Clin Pract. 2012;31(4):205–213. - PMC - PubMed
    1. McCarthy E.T., Sharma M., Savin V.J. Circulating permeability factors in idiopathic nephrotic syndrome and focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2010;5(11):2115–2121. - PubMed
    1. Savin V.J., Sharma R., Sharma M., McCarthy E.T., Swan S.K., Ellis E. Circulating factor associated with increased glomerular permeability to albumin in recurrent focal segmental glomerulosclerosis. N Engl J Med. 1996;334(14):878–883. - PubMed
    1. Savin V.J., McCarthy E.T., Sharma M. Permeability factors in focal segmental glomerulosclerosis. Semin Nephrol. 2003;23(2):147–160. - PubMed

Publication types

LinkOut - more resources