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http://dx.doi.org/10.1016/j.jdcr.2016.08.005DOI Listing

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Cryptococcosis (cryptococcal infection) is a severe life-threatening fungal infection. It is seen worldwide, specifically in immunocompromised, mainly in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-infected individuals. Cryptococcal infection can present with meningitis, pneumonia, peritonitis, disseminated cryptococcosis, and cryptococcal fungemia.

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Optic Perineuritis Associated With Cryptococcal Meningitis Presenting With a "Hot Orbit" in a Patient With Chronic Lymphocytic Leukemia.

J Neuroophthalmol

June 2022

Department of Ophthalmology (DLL, BKC, EDG), Mass Eye and Ear, Boston, Massachusetts; Department of Ophthalmology (EKT), Boston Medical Center, Boston, Massachusetts; Department of Pathology (MYL), Boston VA Medical Center, Boston, Massachusetts; Department of Optometry (JEK), Boston VA Medical Center, Boston, Massachusetts; Department of Radiology (NJF), Stanford University Medical Center, Stanford, California; Department of Ophthalmology (DRL), Boston VA Medical Center, Boston, Massachusetts; Division of Ophthalmic Plastic and Reconstructive Surgery (DRL), Massachusetts Eye and Ear, Boston, Massachusetts; Division of Neuro-Immunology (BKC), Massachusetts General Hospital, Boston, Massachusetts; Department of Ophthalmology (EDG), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; and Picower Institute for Learning and Memory (EDG), Massachusetts Institute of Technology, Cambridge, Massachusetts.

Article Synopsis
  • A 75-year-old man experienced worsening left eye pain, swelling, and difficulty moving his eye, with a medical history of diabetes and chronic lymphocytic leukemia.
  • Imaging showed significant swelling and changes around his optic nerve, leading to a diagnosis of orbital cellulitis initially.
  • Further tests revealed he had cryptococcal meningitis causing optic nerve inflammation, but after a month of antifungal treatment, his symptoms improved despite challenges from immune reconstitution inflammatory syndrome.
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Immune reconstitution inflammatory syndrome (IRIS) is a common complication following the initiation of antiretroviral therapy (ART). The most commonly associated pathogens include Mycobacterium tuberculosis and Cryptococcus spp. IRIS following nontuberculosis mycobacteria (NTM) infection is uncommon, particularly, IRIS following NTM conjunctivitis.

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Cutaneous cryptococcosis, an infectious disease resulting from , primarily affects immunodeficient individuals. Here, we report a case of mediastinal small cell carcinoma (MSCC) complicated with multiple skin and soft tissue infections mimicking erysipelas and cellulitis. Antibiotics for bacteria were ineffective and a culture of pus from the infected areas revealed in this patient.

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Disseminated cryptococcosis primarily affects immunosuppressed patients and has a poor outcome if diagnosis and treatment are delayed. Skin lesions are rarely manifest causing misdiagnosis. We present a case of cryptococcal cellulitis with severe pain in a kidney transplant recipient on long-term immunosuppressive therapy.

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