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Korean J Med > Volume 88(4); 2015 > Article
The Korean Journal of Medicine 2015;88(4): 447-452.
혈액 투석 환자에서 크립토코쿠스혈증을 동반한 크립토코쿠스 연조직염
정일우, 김지은, 김상훈, 김지형, 홍유아, 고강지, 권영주
고려대학교 의과대학 내과학교실 신장내과
Cryptococcus neoformans Cellulitis with Cryptococcemia in a Patient on Maintenance Hemodialysis
Il Woo Jeong, Ji Eun Kim, Sang Hun Kim, Ji Hyoung Kim, Yu Ah Hong, Gang Jee Ko, Young Joo Kwon
Division of Nephrology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
Corresponding Author: Young Joo Kwon ,Tel: +82-2-2626-3036, Fax: +82-2-866-1643, Email: yjkwon@korea.ac.kr
Received: March 24, 2014;   Revised: April 22, 2014;   Accepted: July 28, 2014.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Cryptococcus neoformans is a fungus that causes opportunistic infections in immunocompromised hosts. Skin lesions are found in 10-20% of systemic cryptococcal infections, usually secondary to cryptococcemia, while primary cutaneous cryptococcosis with cryptococcemia is very rare. We report a case of rapidly spreading cryptococcal cellulitis in a 64-year-old male on maintenance hemodialysis taking steroids for encapsulated peritoneal sclerosis. Bluish bullous cellulitis developed on the left forearm and spread rapidly to the other forearm. We identified C. neoformans in the blood and skin lesions. We treated him successfully with liposomal amphotericin B and fluconazole for 15 months. We also review the literature.
Keywords: Cryptococcus neoformans; Cellulitis; Immunocompromised host; Renal dialysis
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