Disseminated Cryptococcosis in An Immunocompetent Host Presenting As Osteomyelitis and Leading to Adrenal Insufficiency.

ABSTRACT

Disseminated cryptococcosis infection typically occurs in immunocompromised patients, often through pneumonia or meningoencephalitis. Cases in immunocompetent patients are uncommon, and presentation in either bone or adrenal glands are rare. We describe a case of a previously healthy immunocompetent 50-year-old woman who presented with lytic bone lesions followed by meningoencephalitis, dermatologic involvement, and adrenal insufficiency from disseminated cryptococcus. To our knowledge, this is the first case report of an immunocompetent patient with cryptococcus in the combination of blood, bone, skin, central nervous system, and adrenal glands. Clinicians should be aware of atypical presentations of cryptococcal disease. In this review of the literature on cryptococcosis in immunocompetent patients, we find that while rare, cryptococcosis can affect varied organs and should be considered in the differential of infectious diseases.