Myositis due to Cryptococcus neoformans in a Diabetic Patient

Sang Taek Heo; In-Gyu Bae; Jin Yong Park; Sun-Joo Kim

doi:10.5145/KJCM.2009.12.3.141

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Heo, Bae, Park, and Kim: Myositis due to Cryptococcus neoformans in a Diabetic Patient

Original Article

Korean J Clin Microbiol 2009;12(3):141-143.

Published online: 22 September 2009

DOI: https://doi.org/10.5145/KJCM.2009.12.3.141

Myositis due to Cryptococcus neoformans in a Diabetic Patient

Sang Taek Heo^1,³, In-Gyu Bae^1,³, Jin Yong Park¹, Sun-Joo Kim^2,³

¹Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea

²Department of Laboratory Medicine, Gyeongsang National University School of Medicine, Jinju, Korea

³Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea

Correspondence: In-Gyu Bae, Department of Internal Medicine, Gyeongsang National University School of Medicine, 90, Chilam-dong, Jinju 660-702, Korea. (Tel) 82-55-750-8055, (Fax) 82-55-758-9122, (E-mail) ttezebae@empal.com

Received 19 May 200928 July 2009 Accepted 15 August 2009

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 non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We report a rare case of cryptococcal myositis with dissemination to lung in a 66-year-old diabetic woman who had no apparent risk factors for cryptococcal disease. She visited the hospital with a continuous pain in the right thigh and fever despite of treatment with antibiotics. She developed a localized lung infiltration. Crytococcus neoformans was isolated from the abscess of the right thigh and confirmed by molecular identification with DNA sequence analysis. Biopsy of the involved lung showed numerous budding yeasts consistent with Cryptocococcus species. The patient was successfully treated with surgical drainage and systemic antifungal agents.

Keywords: Cryptococcus neoformans, Myositis, Diabetes mellitus, Sequence analysis

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Fig. 1.

Enhanced CT of the patient's lower extremity reveals swelling of the right gluteus medius muscle and fluid collection (arrow) between the fascia lata and vastus muscle. There is no evidence of bone involvement.

Fig. 2.

Lung biopsy specimen shows variable sized, small round fungal spores with surrounding clear halo (arrow head). Most spores are found within giant cells in granulomas (arrow) (Gomori methenamine silver (GMS) stain, original magnification ×400).

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