关键词: 面部丘疹, 腰痛, 隐球菌病, 播散性

Abstract: A case of disseminated cryptococcosis was reported. The patient was a 47-year-old female. Low back pain with recurrent facial papules for 3 months. Physical examination showed scattered in the diameter of about 5-7mm skin flat papules on the face. Skin histopathology showed acute inflammatory granulation tissue was formed in the dermis, with more neutrophils and tissue cells gathering, scattered round and oval bright bodies inside and outside the tissue cells, and some red globules in the center. Immunohistochemistry showed AE1/AE3 (epithelial +), CD1a(-), CMV(-), EBER in situ hybridization (-), S100(-), CD68(-). A large number of spores were found by special staining PAS, HE and hexamine silver. A large number of spores with broad capsular membranes were observed under the microscopy. White waxy smooth colony was found in fungal culture and.  identified as Cryptococcus neoforme by molecular biology. The diagnosis of skin cryptococcosis, bone cryptococcosis, hemolytic anemia was made. The patients were treated with 12 thoracic vertebra lesions cleared and oral fluconazole capsule 400 mg/d, there was no recurrence of facial papules and lumbar mass during one year follow-up.

Key words: facial papule, low back pain, cryptococcosis, dissemination