2012 Volume 122 Issue 7 Pages 1765-1772
We report an 82-year old Japanese woman with cutaneous cryptococcosis. She had a history of rheumatoid arthritis with administration of methotrexate and infliximab. Ulcerations of her tongue and face appeared from July 2009, and she was hospitalized by complaints of both fever and loss of appetite from March 2010. Histological examinations and fungal cultures of ulcerations of tongue and face revealed cryptococcosis. On the basis of the presence of Cryptococcus neoformans in her cerebrospinal fluid, the final diagnosis was cryptococcal meningitis. We administered amphotericin B and flucytosine. the ulcerations of tongue and face achieved complete remission, but these antifungal drugs were insufficient for eliminating the meningitis, so we changed her medication and prescribed voriconazole. With this treatment, the data from cerebrospinal fluid examinations improved.
