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