A Case of Disseminated Infection with Skin Manifestation due to Non-neoformans and Non-gattii Cryptococcus in a Patient with Refractory Acute Myeloid Leukemia.
Sun Seob Park, Hyewon Lee, Weon Seo Park, Sang Hyun Hwang, Sang Il Choi, Mi Hong Choi, Si Won Lee, Eun Jung Ko, Young Ju Choi, Hyeon Seok Eom
Author Information
Sun Seob Park: Department of Internal Medicine, National Cancer Center, Goyang, Korea. ORCID
Hyewon Lee: Hematologic Oncology Clinic, National Cancer Center, Goyang, Korea.
Weon Seo Park: Department of Pathology, National Cancer Center, Goyang, Korea.
Sang Hyun Hwang: Department of Laboratory Medicine, National Cancer Center, Goyang, Korea.
Sang Il Choi: Department of Internal Medicine, National Cancer Center, Goyang, Korea.
Mi Hong Choi: Department of Internal Medicine, National Cancer Center, Goyang, Korea.
Si Won Lee: Department of Internal Medicine, National Cancer Center, Goyang, Korea.
Eun Jung Ko: Department of Internal Medicine, National Cancer Center, Goyang, Korea.
Young Ju Choi: Infectious Disease Clinic, National Cancer Center, Goyang, Korea.
Hyeon Seok Eom: Hematologic Oncology Clinic, National Cancer Center, Goyang, Korea. hseom@ncc.re.kr. ORCID
Cryptococcus spp. other than Cryptococcus neoformans or Cryptococcus gattii were previously considered saprophytes and thought to be non-pathogenic to humans. However, opportunistic infections associated with non-neoformans and non-gattii species, such as Cryptococcus laurentii and Cryptococcus albidus, have increased over the past four decades. We experienced a case of cryptococcosis caused by non-neoformans and non-gattii spp. in a 47-year-old female with refractory acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation. The Patient underwent salvage chemotherapy with fluconazole prophylaxis and subsequently developed neutropenic fever with multiple erythematous umbilicated papules. A skin biopsy revealed fungal hyphae and repetitive blood cultures showed yeast microorganisms that were identified later as C. laurentii by Vitek-II®. Skin lesions and fever began to improve with conventional amphotericin B therapy. The treatment regimen was continued for 21 days until the disseminated cryptococcosis was completely controlled.
