Disseminated Skeletal Cryptococcosis: A Case Report

Introduction: Cryptococcus is a rare cause of osteomyelitis, especially in immunocompromised individuals. This case report discusses a rare case of disseminated cryptococcosis with multiple bone lesions in a patient with isolated CD4 lymphocytopenia. Case Report: A 31-year-old apparently normal Indi...

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Main Authors: David Joseph, Prannoy Paul, Vishnu Padmanabhan, Athul Rajesh, Raj Vignesh, Raphael Baby
Format: Article
Language:English
Published: Indian Orthopaedic Research Group 2025-08-01
Series:Journal of Orthopaedic Case Reports
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Online Access:https://jocr.co.in/wp/2025/08/01/disseminated-skeletal-cryptococcosis-a-case-report/
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author David Joseph
Prannoy Paul
Vishnu Padmanabhan
Athul Rajesh
Raj Vignesh
Raphael Baby
author_facet David Joseph
Prannoy Paul
Vishnu Padmanabhan
Athul Rajesh
Raj Vignesh
Raphael Baby
author_sort David Joseph
collection DOAJ
description Introduction: Cryptococcus is a rare cause of osteomyelitis, especially in immunocompromised individuals. This case report discusses a rare case of disseminated cryptococcosis with multiple bone lesions in a patient with isolated CD4 lymphocytopenia. Case Report: A 31-year-old apparently normal Indian male presented with pain and swelling of his right proximal femur for 8 months without any history of trauma. He also reported a similar swelling in his chest wall with allergic respiratory symptoms for 8 years. Laboratory analysis revealed mild elevation in inflammatory markers. Magnetic resonance imaging of the pelvis revealed osteolytic lesions in the right proximal femur and pubic bone with soft tissue collections, and computed tomography scan of the chest showed an osteolytic lesion in the right 9th rib with an overlying soft tissue collection and a subpleural cavitary nodule in the left lower lobe posterior basal segment. Although initially treated as a case of clinically diagnosed tuberculosis, the patient did not get any relief with antitubercular therapy. Fine needle aspiration cytology and fungal culture identified Cryptococcus neoformans from both lesions and from the blood culture. The patient responded well to antifungal treatment and is currently symptom free. Conclusion: Cryptococcosis should be considered as a rare differential diagnosis in patients presenting with bone pain and multiple lytic lesions. Definitive diagnosis requires a fungal culture from the affected areas. Early treatment with antifungals is important in preventing complications and death.
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publishDate 2025-08-01
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spelling doaj-art-c69f682ecd48474e84cc2a27cdb88eab2025-08-20T03:36:58ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-08-0115813013410.13107/jocr.2025.v15.i08.5912Disseminated Skeletal Cryptococcosis: A Case ReportDavid JosephPrannoy PaulVishnu PadmanabhanAthul RajeshRaj VigneshRaphael BabyIntroduction: Cryptococcus is a rare cause of osteomyelitis, especially in immunocompromised individuals. This case report discusses a rare case of disseminated cryptococcosis with multiple bone lesions in a patient with isolated CD4 lymphocytopenia. Case Report: A 31-year-old apparently normal Indian male presented with pain and swelling of his right proximal femur for 8 months without any history of trauma. He also reported a similar swelling in his chest wall with allergic respiratory symptoms for 8 years. Laboratory analysis revealed mild elevation in inflammatory markers. Magnetic resonance imaging of the pelvis revealed osteolytic lesions in the right proximal femur and pubic bone with soft tissue collections, and computed tomography scan of the chest showed an osteolytic lesion in the right 9th rib with an overlying soft tissue collection and a subpleural cavitary nodule in the left lower lobe posterior basal segment. Although initially treated as a case of clinically diagnosed tuberculosis, the patient did not get any relief with antitubercular therapy. Fine needle aspiration cytology and fungal culture identified Cryptococcus neoformans from both lesions and from the blood culture. The patient responded well to antifungal treatment and is currently symptom free. Conclusion: Cryptococcosis should be considered as a rare differential diagnosis in patients presenting with bone pain and multiple lytic lesions. Definitive diagnosis requires a fungal culture from the affected areas. Early treatment with antifungals is important in preventing complications and death.https://jocr.co.in/wp/2025/08/01/disseminated-skeletal-cryptococcosis-a-case-report/cryptococcus neoformanscryptococcal osteomyelitiscryptococcosisosteomyelitis
spellingShingle David Joseph
Prannoy Paul
Vishnu Padmanabhan
Athul Rajesh
Raj Vignesh
Raphael Baby
Disseminated Skeletal Cryptococcosis: A Case Report
Journal of Orthopaedic Case Reports
cryptococcus neoformans
cryptococcal osteomyelitis
cryptococcosis
osteomyelitis
title Disseminated Skeletal Cryptococcosis: A Case Report
title_full Disseminated Skeletal Cryptococcosis: A Case Report
title_fullStr Disseminated Skeletal Cryptococcosis: A Case Report
title_full_unstemmed Disseminated Skeletal Cryptococcosis: A Case Report
title_short Disseminated Skeletal Cryptococcosis: A Case Report
title_sort disseminated skeletal cryptococcosis a case report
topic cryptococcus neoformans
cryptococcal osteomyelitis
cryptococcosis
osteomyelitis
url https://jocr.co.in/wp/2025/08/01/disseminated-skeletal-cryptococcosis-a-case-report/
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AT prannoypaul disseminatedskeletalcryptococcosisacasereport
AT vishnupadmanabhan disseminatedskeletalcryptococcosisacasereport
AT athulrajesh disseminatedskeletalcryptococcosisacasereport
AT rajvignesh disseminatedskeletalcryptococcosisacasereport
AT raphaelbaby disseminatedskeletalcryptococcosisacasereport