A cryptic diagnosis: disseminated cryptococcal disease presenting as an asymptomatic pulmonary nodule and a skin lesion: a case report

BACKGROUND: Cryptococcosis refers to a spectrum of infections caused by the encapsulated yeast Cryptococcus neoformans. In the immunocompromised host cryptococcus may disseminate resulting in significant mortality and morbidity. CASE PRESENTATION: We report the case of a 49-year-old homosexual male presenting with an atypical skin lesion associated with an asymptomatic pulmonary nodule. A subsequent diagnosis of disseminated cryptococcosis was made on India ink staining of cerebrospinal fluid. CONCLUSION: A diagnosis of cryptococcosis should be considered in all patients at risk of immunocompromise that present with asymptomatic pulmonary nodules in the presence of extrapulmonary manifestations, as exemplified by the unusual skin ulceration in our case.