Vertebral Cryptococcosis Infection in an Immunocompetent Host: A Rare Case Report

Abstract

Cryptococcosis is a systemic mycosis caused by yeast like fungus Cryptococcus neoformans. The infection results from inhalation of fungal spores in soil, house dust and in pigeon and other bird excreta. Infection usually occurs in immunocompromised individuals with lung and central nervous system being common sites of involvement. Skeletal involvement usually occurs as a component of disseminated cryptococcosis. Isolated skeletal involvement is rare. Here, the author presents a case of isolated skeletal cryptococcosis in an immunocompetent patient who presented with severe back pain and leg pain. Possibility of Tuberculosis of spine was suggested clinically but histopathology showed cryptococcal granulomas. Patient was HIV seronegative and did not have any other co-morbid conditions. There were no lesions in lung or brain. Because of increasing incidence of crytpococcal infections in immunocompetent hosts it should be included in the differential diagnosis of tuberculosis. Spine and fungal cultures should also be done. In the absence of fungal cultures, histopathological examination including the special stains is useful for diagnosis.

Keywords

• disseminated cryptococcosis
• skeletal cryptococcosis
• tuberculosis spine