Disseminated cryptococcosis revealed by cutaneous manifestations in the course of AIDS

Crytococcosis is a polymorphic affection, frequently described in the cours e of AIDS in Africa, where arise diagnostic and therapeutic problems. The p urpose of this observation is to report a case of disseminated cryptococcos is revealed by cutaneous lesions; the diagnosis was confirmed by biopsy. Th e subject was a 43-year-old African male, diagnosed with HIV-1 infection si nce 1995. He was admitted for persistent fever and skin lesions: vesiculo-p apular, excoriated, semiconfluent eruptions localized on the face and extre mities. CD4 count was 101/mm(3). Chest roengentogram yielded bilateral reti culo-nodular opacities suggestive of miliary tuberculosis. Therapy with int ravenous amphotericin B was initiated, along with antituberculosis regimen; however, the patient did not survive over 15 days. This paper discusses th e misleading nature of atypical skim lesions with respect to HIV. The resul ts of this study should encourage the systematic pratice of skin biopsies a nd the research of other modes of cryptococcal dissemination.