Cryptococcus neoformans most commonly causes pulmonary and central nervous system infections, with skeletal involvement usually occurring as part of disseminated disease in profoundly immunocompromised hosts. We describe an HIV-negative man in his early 50s from South Africa with sarcoidosis, type 1 diabetes mellitus and chronic kidney disease who presented with a 1 month history of a localised swelling over the right anterior chest wall. CT demonstrated an expansile lesion of the right sixth anterior rib. Biopsy and culture confirmed C. neoformans with fluconazole non-susceptibility. The patient was treated with 12 months of voriconazole, achieving clinical and radiological resolution without surgical intervention.
Connolly et al. (Thu,) studied this question.
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