Cryptococcal Cellulitis in Congenital Lymphedema

A 27-year-old woman with intestinal lymphangiectasia and congenital lymphedema developed cryptococcal cellulitis as a result of her underlying depressed cell-mediated immune responsiveness. Prompt therapy with amphotericin B and 5-fluorocytosine resulted in an excellent outcome. The authors believe that the increasing population of patients with depression of cell-mediated immune response will lead to an increase in the frequency with which cryptococcal cellulitis is seen and emphasize that proper evaluation of a patient with presumptive cellulitis includes consideration of fungal, as well as bacterial, etiology.