Cryptococcal subcutaneous abscess associated with a rib osteomyelitis in apatient with AIDS

Background. Cutaneous cryptococcal lesions occurred in 3.5 to 6 % of AIDS p atients with disseminated cryptococcosis and usually include papules, ulcer s, plaques or nodules while subcutaneous abscess have been occasionally obs erved. Observation. Rie describe a patient with AIDS who had a previous history of tuberculosis of the sixth rib 4 months before. He suddenly presented a sub cutaneous abscess and a fine-needle aspiration of the loft-tissue mass yiel ded a whitish fluid in which Cryptococcus neoformans was identified. Chest CT scan showed a soft-tissue mass overlying osteolytic rib. After 10 days o f fluconazole therapy the sixth rib was resected. C. neoformans could be cu ltured from the excised rib confirming the osteomyelitis. Conclusion. This case report confirms the abundant potential sites of crypt ococcosis. Cryptococcal osteomyelitis and arthritis have been rarely descri bed in AIDS patients. When the osteolytic bone is associated with soft-tiss ue lesion mimicking a subcutaneous bacterial abscess, diagnosis is relative ly simple by means of fine-needle aspiration and direct mycological examina tion and culture.