Cryptococcal rib osteomyelitis as primary and only symptom of idiopathic CD4 penia

Rebecca A Legarth; Merete Christensen; Henrik Calum; Terese L Katzenstein; Jannik Helweg-Larsen

doi:10.1016/j.mmcr.2014.02.002

Cryptococcal rib osteomyelitis as primary and only symptom of idiopathic CD4 penia

Med Mycol Case Rep. 2014 Feb 25:4:16-8. doi: 10.1016/j.mmcr.2014.02.002. eCollection 2014 Apr.

Authors

Rebecca A Legarth¹, Merete Christensen², Henrik Calum³, Terese L Katzenstein¹, Jannik Helweg-Larsen¹

Affiliations

¹ Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen O, Denmark.
² Department of Thoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen O, Denmark.
³ Department of Microbiology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen O, Denmark.

Abstract

A 59-year old man with idiopathic CD4 lymphopenia presented with extensive disseminated Cryptococcus neoformans infection including a large rib cryptoccocoma, vertebral spondylitis and pleural empyema. Complete resection of the affected part of the rib was necessary after failure of initial antifungal treatment. The vertebral spondylitis has been successfully managed at 3 years of follow-up by continuous itraconazole treatment and regular MRI combined with leucocyte scintigraphy assessment.

Keywords: C. neoformans; Cryptococcoma; Idiopathic CD4 penia; Spondylitis.