Mixed Pneumocystis and Cryptococcus Cutaneous Infection Histologically Mimicking Xanthoma
| Autor: | Bruce D. Ragsdale, Carolyn A. Smith, Zachary G. Peña, Hugh Randolph Byers, Larisa M. Lehmer |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Antifungal Agents Biopsy Cryptococcus Dermatology Xanthoma Pneumocystis carinii Pathology and Forensic Medicine Diagnosis Differential Predictive Value of Tests Xanthomatosis medicine Dermatomycoses Humans Pneumocystis jirovecii Histiocyte Skin Cryptococcus neoformans AIDS-Related Opportunistic Infections Staining and Labeling biology medicine.diagnostic_test Coinfection business.industry Cryptococcosis General Medicine biology.organism_classification medicine.disease Pneumocystis Infections Treatment Outcome Immunology Sputum medicine.symptom business Meningitis |
| Zdroj: | The American Journal of Dermatopathology. 35:e6-e10 |
| ISSN: | 0193-1091 |
| DOI: | 10.1097/dad.0b013e318266b59a |
| Popis: | Cutaneous Pneumocystis jirovecii infection is rare. It is thought that the disease emerges from a latent infection delivered via hematogenous and/or lymphatic dissemination from a primary lung infection in immunocompromised individuals. A 32-year-old human immunodeficiency virus-positive male was admitted for headache and vomiting. He was diagnosed with meningitis due to Cryptococcus neoformans and sputum tested positive for Pneumocystis. Six months later, he presented with a slightly crusted yellowish brown plaque and 2 similar but smaller papules with telangiectasia near the right angle of the mouth. Biopsy of the area featured histiocytes expanded by foamy cytoplasm as in a xanthoma except that the vacuoles were coarser. Special stains ultimately demonstrated the characteristic disks of Pneumocystis accompanied by a minor component of budding yeasts (Cryptococcus) in the same fields. This case illustrates the utility of adequate special stains in recognizing a mixed cutaneous infection, particularly in human immunodeficiency virus-positive patients, when microscopy presents an odd xanthoma-like lesion. |
| Databáze: | OpenAIRE |
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