Cryptococcosis is an invasive mycosis and can disseminate an infection in immunocompromised hosts. The main sites of infection include the central nervous system and lungs; skeletal infections are rarely reported. We describe the case of a Chinese man in his early 40s with a 1-year history of dermatomyositis and prolonged use of corticosteroids and immunosuppressants. During re-examination of a previously discovered pulmonary nodule, lung computed tomography revealed that the nodule had grown in size, and a bone scan revealed local bone abnormalities and mass formation in the left scapula. The initial diagnosis was lung cancer with bone metastasis; therefore, both lesions were resected. The final histopathological diagnosis was disseminated cryptococcosis. This case presents a rare and atypical manifestation of pulmonary and skeletal cryptococcosis. Thus, cryptococcal infection should be considered in the differential diagnosis in patients presenting with immune insufficiency.
Luo et al. (Sun,) studied this question.