Fungus – Cryptococcosis

Cryptococcosis is a rare “deep fungus” infection that I see occasionally in my The Woodlands dermatology and Conroe dermatology offices.  Cryptococcus neoformans is a fungus that usually infects the lungs.  In 90% of cases, Cryptococcus remains in the lungs and only disseminates to other organs in 10% of cases.  The central nervous system is a very common organ that Cryptocococcus can infect and is the most common cause of fungal meningitis.  The head and neck are the most common sites of Cryptococcusskin infection.  Morphologically, the lesions in cryptococcosis have a myriad appearances such as molloscum contagiosum like papules, subcutaneous nodules, pustules, plaques and cellulitis.  Cryptococcosis can be found worldwide as it is in soil, dust, and pigeon droppings.  Most patients infected with cryptococcosis are usually immunosuppressed as it is a common disease seen in AIDS.  Cryptococcosis can be diagnosed with biopsy or KOH microscopy by adding India ink to the slide, which reveals “narrow based” budding yeast.  Treatment is with systemic antifungals such as Amphotericin in very ill patients or Fluconazole daily for several months.