Cutaneous cryptococcosis mimicking basal cell carcinoma and revealing systemic involvement in acquired immunodeficiency
Cutaneous cryptococcosis mimicking basal cell carcinoma and revealing systemic involvement in acquired immunodeficiency
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DOI：
10.1016/j.mycmed.2015.04.002
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发表时间：
2015-06-01
影响因子：
3.6
通讯作者：
Amal, S.
中科院分区：
文献类型：
--
作者：
Atarguine, H.;Hocar, O.;Amal, S.
背景。隐球菌病是一种罕见和严重的机会性感染，主要发生在免疫缺陷领域。我们报告一例获得性免疫缺陷综合征的播散性隐球菌病，表现为不寻常的皮肤病变。一名52岁的患者因6个月前出现的位于左眶上和鼻尖的两个硬痂性溃疡病变而就诊。他还报告一年以来出现呼吸道症状，干咳、呼吸困难、慢性头痛和呕吐，视力无改变。对两个病变的皮肤活检进行真菌学研究，分离出新型隐球菌以及痰和脑脊液。人类免疫缺陷病毒感染血清学阳性。采用氟康唑、局部护理和抗逆转录病毒三联疗法治疗。-隐球菌病期间的皮肤损伤是罕见的，在2-10%的病例中观察到。皮肤症状是我们患者就诊的原因。这是一种罕见的皮肤隐球菌病，可导致肺部和中枢神经系统的发现，并可诊断为HIV感染。(C) 2015年Elsevier Masson SAS出版。
Background. - Cryptococcosis is a rare and a serious opportunistic infection that occurs primarily on the field of immunodeficiency. We report a case of disseminated cryptococcosis in acquired immunodeficiency syndrome revealed by unusual skin lesions.Observation. - A 52-year-old patient consulted for two crusty ulcerative lesions situated on the Left supraorbital and on the nasal tip that appeared 6 months ago. He also reported respiratory symptoms present since one year, with dry cough and dyspnea, chronic headache and vomiting with no alteration in visual acuity. The mycological study of the skin biopsy on both lesions isolated Cryptococcus neoformans as well as in the sputum and cerebrospinal fluid. Serology of human immunodeficiency virus infection was positive. Treatment with fluconazole, local care and antiretroviral triple therapy was implemented.Discussion. - Skin lesions during cryptococcosis are rare and observed in 2-10% of cases. Cutaneous symptoms were the reason for consultation in our patient. This is a rare form of cutaneous cryptococcosis leading to the discovery of both pulmonary and central nervous system Locations, and to diagnosis of HIV infection. (C) 2015 Published by Elsevier Masson SAS.