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Chronic skull osteomyelitis due to Cryptococcus neoformans: first case report in an HIV-infected patient

Osteomyelitis due to Cryptococcus neoformans are described in mostly 10% of patients with disseminated cryptococcosis, being direct inoculation even more uncommon. We report the case of an HIV-infected patient with history of recurring itching on his scalp and repetitive local trauma. For eighteen m...

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Autores principales: Adiwardana, Natanael Sutikno, Morás, Juliana de Angelo, Bernardo, Leandro Lombo, Klautau, Giselle Burlamaqui, Queiroz, Wladimir, Vidal, Jose Ernesto
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9425647/
https://www.ncbi.nlm.nih.gov/pubmed/30528189
http://dx.doi.org/10.1016/j.bjid.2018.11.004
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author Adiwardana, Natanael Sutikno
Morás, Juliana de Angelo
Bernardo, Leandro Lombo
Klautau, Giselle Burlamaqui
Queiroz, Wladimir
Vidal, Jose Ernesto
author_facet Adiwardana, Natanael Sutikno
Morás, Juliana de Angelo
Bernardo, Leandro Lombo
Klautau, Giselle Burlamaqui
Queiroz, Wladimir
Vidal, Jose Ernesto
author_sort Adiwardana, Natanael Sutikno
collection PubMed
description Osteomyelitis due to Cryptococcus neoformans are described in mostly 10% of patients with disseminated cryptococcosis, being direct inoculation even more uncommon. We report the case of an HIV-infected patient with history of recurring itching on his scalp and repetitive local trauma. For eighteen months, he noticed a painful and slow growing lump on his scalp. He was submitted to an excisional biopsy of the lesion but no etiological diagnosis was identified. After this procedure, the post-surgical wound never completely healed. At admission, the patient presented nausea and headache for three days and an open orifice into his skull. Investigations confirmed meningitis and skull osteomyelitis caused by Cryptococcus neoformans. He was treated with bone debridement and combined systemic antifungals, showing good clinical and laboratorial outcome. Cryptococcal disease should be included in the differential diagnoses of chronic osteomyelitis in HIV-infected patients and trauma is a possible source of infection.
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spelling pubmed-94256472022-08-31 Chronic skull osteomyelitis due to Cryptococcus neoformans: first case report in an HIV-infected patient Adiwardana, Natanael Sutikno Morás, Juliana de Angelo Bernardo, Leandro Lombo Klautau, Giselle Burlamaqui Queiroz, Wladimir Vidal, Jose Ernesto Braz J Infect Dis Case Report Osteomyelitis due to Cryptococcus neoformans are described in mostly 10% of patients with disseminated cryptococcosis, being direct inoculation even more uncommon. We report the case of an HIV-infected patient with history of recurring itching on his scalp and repetitive local trauma. For eighteen months, he noticed a painful and slow growing lump on his scalp. He was submitted to an excisional biopsy of the lesion but no etiological diagnosis was identified. After this procedure, the post-surgical wound never completely healed. At admission, the patient presented nausea and headache for three days and an open orifice into his skull. Investigations confirmed meningitis and skull osteomyelitis caused by Cryptococcus neoformans. He was treated with bone debridement and combined systemic antifungals, showing good clinical and laboratorial outcome. Cryptococcal disease should be included in the differential diagnoses of chronic osteomyelitis in HIV-infected patients and trauma is a possible source of infection. Elsevier 2018-12-06 /pmc/articles/PMC9425647/ /pubmed/30528189 http://dx.doi.org/10.1016/j.bjid.2018.11.004 Text en © 2018 Sociedade Brasileira de Infectologia. Published by Elsevier España, S.L.U. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Adiwardana, Natanael Sutikno
Morás, Juliana de Angelo
Bernardo, Leandro Lombo
Klautau, Giselle Burlamaqui
Queiroz, Wladimir
Vidal, Jose Ernesto
Chronic skull osteomyelitis due to Cryptococcus neoformans: first case report in an HIV-infected patient
title Chronic skull osteomyelitis due to Cryptococcus neoformans: first case report in an HIV-infected patient
title_full Chronic skull osteomyelitis due to Cryptococcus neoformans: first case report in an HIV-infected patient
title_fullStr Chronic skull osteomyelitis due to Cryptococcus neoformans: first case report in an HIV-infected patient
title_full_unstemmed Chronic skull osteomyelitis due to Cryptococcus neoformans: first case report in an HIV-infected patient
title_short Chronic skull osteomyelitis due to Cryptococcus neoformans: first case report in an HIV-infected patient
title_sort chronic skull osteomyelitis due to cryptococcus neoformans: first case report in an hiv-infected patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9425647/
https://www.ncbi.nlm.nih.gov/pubmed/30528189
http://dx.doi.org/10.1016/j.bjid.2018.11.004
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