Case Reports in Infectious Diseases

Case Report

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

Table 1

Clinical characteristics of cases reports of PCC in English language literature searched on PubMed.
CitationYearAge/genderRegion of originImmune statusOccupation/exposureSite of lesionType of lesionSpeciesMedical treatmentDuration of therapyTopical careOutcome
[6]201468/male (M)Southeast BrazilImmunocompetentBus driver ForearmNodule Cryptococcus gattii Fluconazole (200 mg/d)40 daysNone documentedCured
[7]20138/female (F)Spain (child from Mongolia)ImmunocompetentNot reportedForearmMaculeC. laurentii Fluconazole (3 mg/kg/d)2 weeksNone documentedCured
[8]201387/MRural area of TaiwanImmunocompetentNot reported ArmIndurated papules and plaquesC. neoformans Fluconazole 400 mg/d for 2 weeks followed by 200 mg/d for 2 weeks1 monthNone documentedCured
[9]201266/MRural Central AmericaImmunocompetentNot reportedPenisNoduleNo fungal cultureItraconazole (400 mg/d)3 monthsNone documentedCured
[10]201289/MBrazilImmunocompetentCollects firewoodForearmUlcerationC. gattii Itraconazole (400 mg/d)3 monthsNone documentedCured
[11]201258/MGreeceImmunocompetentPoultry farmer HandUlcerationC. neoformans Fluconazole (200 mg/d)2 weeksSurgical debridementCured
[12]2012Case series of 11 patients, mean age 71.2/9M2FBrazil5 immunocompetent, 6 on corticosteroid therapy5 reported trauma or exposure to contaminated sourcesForearmCircumscribed lesions ranged from an infiltrative plaque to a solid tumor mass3 C. neoformans 
4 C. gattii 
4 C. spp. 		Fluconazole (150 mg/d–400 mg/d)1–6 monthsNone documented9 cured,
1 unrelated death,
1 marked improvement
[13]201255/MNot reportedRenal transplant recipientNot reportedThighUmbilicated C. laurentii Amphotericin B + flucytosine7 days
(patient deceased)		None documentedLocal lesion improving; however, patient deceased due to other causes
[14]201167/MNot reportedImmunocompetentPoultry farmerForearmNoduleC. neoformans Fluconazole (450 mg/d)40 daysNone documentedCured
[15]201137/MSingaporeImmunocompetentForklift driver ScalpNoduleC. gattii Not reported
[16]201175/MBrazilImmunocompetentHandles Eucalyptus logsForearmNoduleC. gattii Fluconazole5 monthsNone documentedCured
[17]201060/MSloveniaRenal transplant recipientCat scratchHandNecrosisC. neoformans Amphotericin B + fluconazole3 weeks (amp. + fluc.) + 15 weeks (fluc.)Surgical debridement, amputation of the armHealed
[18]201058/MItalyImmunocompetent Collects firewood HandNoduleC. neoformans Itraconazole (200 mg/d)4 monthsNone documentedCured
[19]200543/MSaudi ArabiaImmunocompetentDriver for a furniture companyForeheadNoduleC. neoformans Not reported
[20]200526/MJapanLong-term prednisolone therapy for minimal change nephrotic syndromeNot reportedLegNoduleC. neoformans Intravenous fluconazole3 monthsNone documentedCured
[21]200573/MSpainLiver transplant recipientInsect bite in Costa Rica 2 days prior to presentationArmIntense edema and suppurationC. neoformans Amphotericin B + fluconazole (100 mg/d)15 days (amp. + fluc.) + 3 months (fluc.)Surgical debridement and reconstructionCured
[22]200457/MNot reportedLung transplant recipientGardenerLegUlcerationC. neoformans Fluconazole (200 mg/d)2 monthsNone documentedCured
[23]200481/MNot reportedImmunocompetentCattle farmerForearmPustulesC. neoformans Fluconazole (400 mg/d)2 monthsNone documentedCured
[4]200341/MSouthern Wisconsin ImmunocompetentPuncture wound from hay bale wire in a barnHandErythematous noduleC. neoformans Fluconazole (400 mg/d)8 weeksSurgical excision Cured
[24]200246/MNot reportedImmunocompetentNot reportedFingerCellulitis C. neoformans Itraconazole (200 mg/d)10 monthsSurgical excisionCured
[25]200265/MBrazilImmunocompetentNot reportedForearmUlcerationC. gattii Fluconazole (150 mg/d)45 daysNone documentedCured
[26]200036/FNot reportedLiver transplant recipient for Budd-Chiari syndromeNot reportedLegUlcerationC. neoformans Fluconazole (200 mg/d)3 monthsNone documentedCured
[27]199775/MAustraliaImmunocompetentOrchid growerForearmTender, erythemaC. gattii Amphotericin B + 5-flucytosine Itraconazole (200 mg/d)3 weeks
3 months 		Normal saline and miconazole cream applied once dailyCured
[28]199777/MNot reportedLong-term steroid treatmentChronic obstructive pulmonary diseaseHandUlcerationC. neoformans Amphotericin B + fluconazole12 days + 6 weeksNone documentedCured
[29]199662/FNot reportedLong-term steroid treatmentSarcoidosis ForearmBullousC. neoformans Itraconazole (400 mg/d)Not reportedNone documentedCured
[30]199573/FJapanImmunocompetentNot reportedCheeksUlcerationC. neoformans No antifungal therapyNot reported Cured
[5]199252/MNot reportedRenal transplant recipientUndergoing surgery for below knee amputation Leg stumpNecrosisC. neoformans Amphotericin BPatient deceased Surgical debridementPatient died of multisystem organ failure
[5]199255/MNot reportedRenal transplant recipient Polycystic kidney diseaseForearmNoduleC. neoformans Amphotericin B + 5-fluorocytosineNot reportedNone documentedCured
[5]199227/FNot reportedSevere lymphopeniaHereditary lymphangiectasiaLegs, lower abdomen, and groin NecrosisC. neoformans Amphotericin B + 5-fluorocytosineNot reportedNone documentedCured
[31]199063/FJapanImmunocompetentHousewifeEarlobeErosion C. neoformans Itraconazole (100 mg/d)13 weeks Cured
[32]19867/MNot reportedNonspecific failure in cellular immunityNot reportedPostauricular Not reportedC. neoformans No antifungal therapy  Spontaneous healing
[33]198553/MNot reportedLong-term corticosteroid therapy for asthmaPigeon fancier WristMassC. neoformans Ketoconazole 3 months Cured
[34]198181/MNot reportedImmunocompetentNot reportedForearm——IV and oral miconazole25 daysNone documentedCured