The patient had previously undergone a procedure for autologous arteriovenous fistula (AVF) 4 years ago, in preparation for hemodialysis. He had also been prescribed oral prednisolone as part of the treatment protocol for peritoneal sclerosis, which he was taking in a dose of 10–45 mg per day for 5 months. The patient was treated with intravenous cefotaxime and ciprofloxacin for bacterial peritonitis and peritonectomy was carried out as treatment for peritoneal sclerosis. Bacterial culture from the ascitic fluid confirmed Klebsiella pneumoniae infection. He had developed recurrent episodes of spontaneous bacterial peritonitis during the treatment and encapsulating peritoneal sclerosis, probably secondary to the peritonitis. He had chronic kidney disease for the past 20 years for which he was undergoing continuous ambulatory peritoneal dialysis.
#Disseminated cryptococcus india ink stain skin
We report cryptococcal infection presenting as cellulitis in a patient with renal failure, undergoing oral steroid therapy.Ī 63-year-old man was referred for skin lesions over the left forearm accompanied by high fever, for three weeks. ,, Cryptococcal cellulitis is not commonly considered as a differential diagnosis in a patient without acquired immunodeficiency syndrome (AIDS) or history of undergoing organ transplant. Major cutaneous findings include umbilicated or acneiform papules, pustules progressing to crusted plaques, or nodules.
The cutaneous lesions develop as a result of dissemination or rarely, through direct inoculation. Cryptococcosis is commonly associated with immunosuppression and the primary site of infection is usually lungs however, a cutaneous form of infection is seen in about 6–10% of patients.
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