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Case Reports in Pediatrics
Volume 2013, Article ID 563081, 4 pages
http://dx.doi.org/10.1155/2013/563081
Case Report

Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature Review

1Department of Hematology, Children’s Hospital, Zhengzhou, 255 Gangdu Road, Henan 450052, China
2Department of Radiology, The First Affilicated Hospital of Zhengzhou University, Zhengzhou, 1 Jianshe East Road, Henan 450000, China

Received 20 March 2013; Accepted 29 April 2013

Academic Editors: C. F. Classen, J. Kobr, C. Modesto, I. Riaño Galán, and A. T. Soliman

Copyright © 2013 Fengchang Bao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a rare case of cryptococcal lymphadenitis without immunocompromization in a two-and-a-half-year-old child. He was referred to our center with a fifteen-day history of continued fever. Ultrasound and computed tomography (CT) revealed the enlargement of multiple lymph nodes and lung reticulonodular shadows. Hematological, immunological, and microbiological tests for hepatitis, lymphoma, AIDS, and immunoglobulin deficiencies were negative. Laboratory tests demonstrated elevated erythrocyte sedimentation rate, elevated plasma and urinary ß2-microglobulin (ß2-MG) levels, and elevated C-reactive protein and fibrinogen. Both blood routine and bone marrow aspiration showed elevated eosinophil granulocytes. The diagnosis of cryptococcal lymphadenitis was obtained by excisional biopsy of the cervical lymph nodes. The patient was treated with intravenous amphotericin B and oral flucytosine for five weeks, then with subsequent oral fluconazole for three months. The patient is now doing well. Our case suggests that the diagnosis of cryptococcal lymphadenitis is very difficult without etiology and pathology, especially for a patient with a normal immune system; lymph node biopsy is necessary to diagnose it, and immediate antifungal treatment is necessary to treat it.