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Case Reports
. 2020 Jan 11:19:e00700.
doi: 10.1016/j.idcr.2020.e00700. eCollection 2020.

The detection of Cryptococcus in skeletal infection after tooth extraction in an acute myeloid leukemia patient

Hiroshi Inoue  1 , Tomokazu Motohashi  2 , Yusuke Ioku  1 , Masahiro Watanabe  1 , Masahiro Nakajima  2 , Mitsuchika Sugitatsu  1   2
Affiliations
Case Reports

The detection of Cryptococcus in skeletal infection after tooth extraction in an acute myeloid leukemia patient

Hiroshi Inoue et al. IDCases. .

Abstract

Cryptococcus is a mycosis founded in immunocompromised patients. Cryptococcus in the oral cavity is rare and skeletal infection is uncommon. We report the case of a 31-year-old man in whom cellulitis developed due to infection after tooth extraction complicated by acute myeloid leukemia (AML). Cellulitis of the left mandible did not improve after conservative therapy, including antimicrobial therapy, because of AML and chemotherapy, and gas was generated in the left cervical and supraclavicular regions. We considered the infection symptoms to be life-threatening, and surgery was performed for the infection of the head and neck under poor general conditions. As histopathological examination of the removed tissue revealed cryptococcus, antifungal agents were administered for cryptococcal infection. The surgical site healed after the operation. Surgical treatment, including debridement and drainage, should be avoided for patients with a poor general condition caused by AML and chemotherapy. However, the detection of Cryptococcus in the surgical site in such a condition is important.

Keywords: Acute myeloid leukemia; Cryptococcus; Skeletal infection.

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Figures

None
Graphical abstract
Fig. 1
Fig. 1
(A) Contrast-enhanced computed tomography (CT) imaging showed gas in the left cervical and supraclavicular regions (arrow). (B) The infected granulation tissue, necrotic tissue and irregular bone in surgical treatment. (C) Periodic Acid Schiff (PAS) staining for examination of the removed bone (×400). (D) Grocott staining for examination of the removed bone (×400).
See this image and copyright information in PMC

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