Primary Cutaneous Cryptococcosis Treated with Debridement and Fluconazole Monotherapy in an Immunosuppressed Patient: A Case Report and Review of the Literature

Figure 1

Primary cutaneous cryptococcosis of the right forearm. Progressive skin changes documented at the initial visit to the emergency department on the third day of symptoms (a), during hospitalization (b-c), and at postdischarge clinic follow-up (d). White arrows denote the outlines of the region of erythema marked on each respective day prior to presentation (i.e., Days 1–3). Fluconazole was initiated along with two interrupted doses of amphotericin on Day 3. Broad-spectrum antibacterial therapy with vancomycin and piperacillin-tazobactam (Day 5–Day 7), ampicillin-sulbactam (Day 8–Day 10), and amoxicillin-clavulanate (Day 11–Day 17) was also administered. (e) Wound improvement seen on one-week follow-up in clinic. The gram stain (f) from fluid expressed on Day 5 demonstrated abundant variably sized encapsulated spherical yeast forms () that were identified as C. neoformans on blood agar.

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