中国麻风皮肤病杂志 ›› 2026, Vol. 42 ›› Issue (11): 786-791.doi: 10.12144/zgmfskin202611786

• 临床研究 • 上一篇    下一篇

以隐球菌性脂膜炎为首发表现的播散性隐球菌病一例

曹丹,吕小岩   

  1. 四川大学华西医院皮肤科,四川成都,610041
  • 出版日期:2026-11-15 发布日期:2026-10-29

Cryptococcal panniculitis as the initial manifestation of disseminated cryptococcosis: a case report

CAO Dan, LYU Xiaoyan   

  1. Department of Dermatology, West China Hospital, Sichuan University, Chengdu 610041, China
  • Online:2026-11-15 Published:2026-10-29

摘要: 隐球菌性脂膜炎是隐球菌感染的一种罕见表现,临床容易误诊。本文报道一例肾移植受者以隐球菌性脂膜炎为首发表现,随后进展为累及中枢神经系统、肺及心脏的播散性隐球菌病。患者经两性霉素B脂质体联合氟胞嘧啶诱导治疗后好转出院,序贯氟胞嘧啶联合氟康唑巩固;出院13天因呼吸困难再入院,CT示右肺下叶空洞进展,予两性霉素B脂质体联合氟康唑治疗后病灶吸收出院,继续氟康唑巩固,第150天随访一般情况良好、无神经系统后遗症,病情稳定。

关键词: 隐球菌性脂膜炎, 播散性隐球菌病, 皮肤隐球菌病, 免疫抑制, 器官移植

Abstract: Cryptococcal panniculitis is a rare manifestation of cryptococcal infection and is prone to clinical misdiagnosis. We report a case of disseminated cryptococcosis presenting initially as cryptococcal panniculitis in a kidney transplant recipient, which subsequently progressed to involve the central nervous system, lungs, and heart. The patient improved and was discharged after induction therapy with liposomal amphotericin B combined with flucytosine, followed by consolidation therapy with oral flucytosine plus fluconazole. Thirteen days after discharge, the patient was readmitted due to dyspnea; chest CT revealed progressive right lower lobe pulmonary cavity. Treatment with liposomal amphotericin B and fluconazole was administered, resulting in lesion resolution and subsequent discharge. The patient continued fluconazole consolidation. At the last follow-up on day 150, the patient was in good general condition without neurological sequelae and remained stable.

Key words: cryptococcal panniculitis, disseminated cryptococcosis, cutaneous cryptococcosis, immunosuppression, organ transplantation