Cryptococcosis during systemic glucocorticosteroid treatment

Cryptococcosis is an opportunistic infection caused by a fungus, Cryptococc us neoformans. It is usually seen in immunocompromised patients with AIDS, leukaemia, lymphoma, sarcoidosis or immunosuppressive treatments. We descri be a patient who was treated with systemic glucocorticosteroids for 4 years because of lung sarcoidosis. During the last year of treatment, a papular eruption developed which later became ulcerative, In a histopathological ex amination of a skin biopsy, there was granulomatous inflammation, and the d isease was treated as sarcoidosis without success. After 1 year's unsuccess ful treatment, another skin biopsy and skin fungal culture revealed C. neof ormans. Cryptococcal antigen was found in blood and cerebrospinal fluid, ta o. The patient was successfully treated first with an amphotericin-B-flucyt osine combination and later with fluconazole.