Oral cryptococosis in an immunosuppressed patient: a case report

A 57-year-old male patient, immunosuppressed after heart transplantation, was hospitalized for suspected disseminated opportunistic infection. The patient complained of pain due to lesions in the mouth, fever, and diarrhea starting 15 days ago. Upon physical examination, crateriform erythematous ulcers covered by a purulent membrane were observed in the anterior region of the hard palate and upper labial mucosa, in addition to erythematous plaques on the upper attached gingiva. Ulcers were also observed in the nose wing and mentual region. Chest tomography revealed irregular reticular opacities in both lungs and ground-glass infiltrate. Biopsies from lung oral lesions were performed, which revealed a granulomatous inflammatory process and small rounded structures. Special Grocott-Gomori staining allowed confirmation of the fungal structure of Cryptococcus, and a final diagnosis of Cryptococcosis was reached. Treatment was conducted with Amphotericin B associated with Fluconazole, and after seven months of follow-up, complete remission of the lesions was observed. Support: CAPES, CNPq. A 57-year-old male patient, immunosuppressed after heart transplantation, was hospitalized for suspected disseminated opportunistic infection. The patient complained of pain due to lesions in the mouth, fever, and diarrhea starting 15 days ago. Upon physical examination, crateriform erythematous ulcers covered by a purulent membrane were observed in the anterior region of the hard palate and upper labial mucosa, in addition to erythematous plaques on the upper attached gingiva. Ulcers were also observed in the nose wing and mentual region. Chest tomography revealed irregular reticular opacities in both lungs and ground-glass infiltrate. Biopsies from lung oral lesions were performed, which revealed a granulomatous inflammatory process and small rounded structures. Special Grocott-Gomori staining allowed confirmation of the fungal structure of Cryptococcus, and a final diagnosis of Cryptococcosis was reached. Treatment was conducted with Amphotericin B associated with Fluconazole, and after seven months of follow-up, complete remission of the lesions was observed. Support: CAPES, CNPq.