Primary Cutaneous Cryptococcosis: A Distinct Clinical Entity

Cryptococcus neoformans is an encapsulated yeast responsible for disseminated meningitis in immunocompromised hosts. Controversies persist on the existence of primary cutaneous cryptococcosis (PCC) versus cutaneous cryptococcosis being only secondary to hematogenous dissemination. Thus, we reviewed...

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Bibliographic Details
Published in:Clinical infectious diseases 2003-02, Vol.36 (3), p.337-347
Main Authors: Neuville, Ségolène, Dromer, Françoise, Morin, Odile, Dupont, Bertrand, Ronin, Olivier, Lortholary, Olivier
Format: Article
Language:English
Subjects:
Adult
Aged
AIDS
Cellulitis
Cryptococcosis
Cryptococcosis - diagnostic imaging
Cryptococcosis - drug therapy
Cryptococcosis - epidemiology
Cryptococcosis - microbiology
Cryptococcus neoformans
Cryptococcus neoformans - classification
Dermatomycoses - diagnostic imaging
Dermatomycoses - drug therapy
Dermatomycoses - epidemiology
Dermatomycoses - microbiology
Female
Fungal infections
Humans
Infections
Lesions
Male
Middle Aged
Physical trauma
Radiography
Review Article
Skin
Skin diseases
Treatment Outcome
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Summary:Cryptococcus neoformans is an encapsulated yeast responsible for disseminated meningitis in immunocompromised hosts. Controversies persist on the existence of primary cutaneous cryptococcosis (PCC) versus cutaneous cryptococcosis being only secondary to hematogenous dissemination. Thus, we reviewed cryptococcosis cases associated with skin lesions reported in the French National Registry. Patients with PCC (n = 28) differed significantly from those with secondary cutaneous cryptococcosis (n = 80) or other forms of the disease (n = 1866) by living area (mostly rural), age (older), ratio of men to women (∼1:1), and the lack of underlying disease. Evidence of PCC included the absence of dissemination and, predominantly, a solitary skin lesion on unclothed areas presenting as a whitlow or phlegmon, a history of skin injury, participation in outdoor activities, or exposure to bird droppings, and isolation of C. neoformans serotype D. Therefore, PCC is a distinct epidemiological and clinical entity with a favorable prognosis even for immunocompromised hosts.
ISSN:1058-4838
1537-6591
DOI:10.1086/345956