Rare Cutaneous Presentation of Disseminated Cryptococcus gattii Infection in an Immunocompetent Male: A Case Report.

Cryptococcosis is a systemic mycosis caused by Cryptococcus neoformans and Cryptococcus gattii, affecting mainly immunocompromised and immunocompetent hosts, respectively. Cutaneous involvement may indicate secondary hematogenous dissemination from systemic disease or, less frequently, primary cutaneous cryptococcosis resulting from direct inoculation without systemic infection. Although cutaneous cryptococcosis can present with diverse morphologies, cutaneous involvement is uncommon in C. gattii infection and is more frequently associated with C. neoformans. We present the case of a 56-year-old immunocompetent man from northern Mexico who developed progressive neurological symptoms accompanied by disseminated cutaneous macules. Cerebrospinal fluid and skin biopsy confirmed C. gattii. The case highlights the need to consider this pathogen in immunocompetent hosts with unexplained meningoencephalitis. Induction therapy with liposomal amphotericin B and fluconazole was initiated, leading to resolution of the cutaneous manifestations.