Cryptococcal hepatitis presenting as a surgical emergency. First isolation of Cryptococcus neoformans from point source in Chicago

Abstract

The report of a case of cryptococcosis classically presents the total clinical expression of this fungal disease from the acute pulmonary infection, acquired by inhalation of infected pigeon excreta, through spontaneous remission and finally severe dissemination resulting from reactivation of a pulmonary focus. Because of symptoms of an acute abdominal emergency, an exploratory laparotomy was performed. Cryptococcal hepatitis, producing significant hepatic dysfunction, was thus diagnosed. The intravenous administration of amphotericin B in a total dose of 3 gm resulted in apparent cure. The first successful isolations of Cryptococcus neoformans from pigeon excreta collected in the city of Chicago were accomplished.