![]() However, isolated cryptococcal osteomyelitis is a rare entity that accounts for approximately 5% of patients with cryptococcosis. Disseminated cryptococcosis is a well-known complication of cryptococcal pneumonia or meningitis. ![]() Immunocompetent patients with isolated osteomyelitis may be cured with oral fluconazole alone.Ĭryptococcosis is an opportunistic infection that typically occurs in immunocompromised hosts such as patients with acquired immunodeficiency syndrome, hematologic malignancy, hepatic failure, and sarcoidosis, who underwent stem cell or solid organ transplant, or those on long-term steroid therapy. Conclusionsįine-needle aspiration cytology, needle biopsy, and fungal culture were useful for definitive diagnosis. The patient has no cosmetic abnormalities or sequelae. There are no signs of recurrence as of 15-month follow-up. Fluconazole therapy was stopped after 6 months. The treatment was effective, and all symptoms were resolved in 4 weeks. Therefore, the patient was diagnosed with isolated cryptococcal osteomyelitis and was initiated on fluconazole therapy. No evidence of any other site involvement was observed. Furthermore, culture of the aspirate showed growth of Cryptococcus neoformans. Histopathological examination of fine-needle aspirate and needle biopsy showed cryptococcus. ![]() A part of the lesion has extended to the subcutaneous area of the cheeks with signs of bone destruction and surrounding contrast effects. Computed tomography showed a 30-mm-diameter lesion at the right zygomatic arch. Laboratory data showed mildly elevated inflammatory indices (C-reactive protein: 0.45 mg/dL erythrocyte sedimentation rate: 35 mm/h). Clinical examination revealed a tender swelling in the right zygomatic region the maximal mandibular opening was about 2 cm. Case presentationĪ 78-year-old man without other comorbidities presented with progressive swelling of the right cheek along with pain and trismus. To the best of our knowledge, no cases of cryptococcal osteomyelitis affecting only the zygomatic bone have been reported to date. Cryptococcal osteomyelitis in the head and neck region is extremely rare. Disseminated cryptococcosis is a well-characterized complication in immunocompromised patients with cryptococcal pneumonia or meningitis however, isolated cryptococcal osteomyelitis is a rare entity that occurs in approximately 5% of patients with cryptococcosis.
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