Successful Treatment of Extensive Primary Cutaneous Cryptococcosis in Patients of Different Immune Status with Combination of Surgery and Antifungal Agents-Two Case Reports

Abstract

We reported two cases of extensive primary cutaneous cryptococcosis successfully treated with combination of early surgical debridement and antifungal agents. Initially both cases mimic bacterial infection and were treated with antibiotics and simple debridement only. The definite diagnosis of primary cutaneous cryptococcosis was confirmed by pathologic findings and fungus cultures. The first case was an immunocompetent female and was successfully treated with aggressive debridement and fluconazole. The second case was an immunocompetent male with diabetes mellitus, liver cirrhosis and chronic hepatitis B and C. Fluconazole was ineffective in this case. The lesions were cured with aggressive debridement and amphotericin B. The choice of antifungal agents should depend on the immune status of the patient but aggressive debridement plays an important role in management of the extensive primary cutaneous cryptococcosis.