Volume 204 - Issue 9
A patient with sarcoidosis and a cryptococcal infection of the skull
Authors: Paul A Rootjes, Wouter Rozemeijer and Jacob C Dutilh
Med J Aust 2016; 204 (9): 353. || doi: 10.5694/mja16.00139
Published online: 16 May 2016
Published online: 16 May 2016
n/a
A 29-year-old man of European ancestry, with a history of sarcoidosis treated with low-dose steroids, presented with a progressive swelling of the skull which had appeared 3 weeks earlier.
Physical examination revealed a 2.5 cm soft swelling of the right parietal part of the skull. A contrast-enhanced magnetic resonance imaging scan of the head showed a solitary lesion of the right parietal bone measuring 9 mm × 17 mm.
After neurosurgical resection, pus cultures grew Cryptococcus neoformans.
In the absence of disseminated cryptococcosis, the patient was treated successfully with oral fluconazole. Current literature suggests sarcoidosis as a risk factor for cryptococcosis, independent of the use of immunosuppressive agents.1,2
References
- Bernard C, Maucort-Boulch D, Varron L, et al. Cryptococcosis in sarcoidosis: cryptOsarc, a comparative study of 18 cases. Q J Med 2013; 106: 523-539.
- Jamilloux Y, Valeyre D, Lortholary O, et al. The spectrum of opportunistic diseases complicating sarcoidosis. Autoimmun Rev 2015; 14: 64-74.