Cryptic presentation of cryptococcal osteomyelitis in an apparently immunocompetent individual

  • Hariharan Subramony Apollo Hospitals, Chennai
  • Balagurunathan Raghavan
  • Eswer Subbaiyan
  • Manjunatha Gajanana Hegde
  • Kartik Ramanathan


Cryptococcus, cryptococcosis, cryptococcal osteomyelitis, immunocompetent


Cryptococcosis is an opportunistic fungal infection seen in immunocompromised individuals. It is caused by the yeast-like fungus Cryptococcus and predominantly affects the lungs and central nervous system. Immunocompetent individuals very rarely develop bone involvement and only a few cases of cryptococcal osteomyelitis in patients without other comorbid conditions have been described. Only one other case of pelvic involvement, which was accompanied by lymphopaenia, has been reported. We describe the case of a 42-year-old immunocompetent man with cryptococcal hip osteomyelitis.



  • Jameson JL, Kasper D, Hauser S, Longo D, Fauci A, Loscalzo J. Harrison’s Principles of Internal Medicine. 19th ed. New York: McGraw Hill Medical; 2015.
  • Al-Tawfiq JA, Ghandour J. Cryptococcus neoformans abscess and osteomyelitis in an immunocompetent patient with tuberculous lymphadenitis. Infection 2007 Oct;35:377–382.
  • Medaris LA, Ponce B, Hyde Z, Delgado D, Ennis D, Lapidus W, et al. Cryptococcal osteomyelitis: a report of 5 cases and a review of the recent literature. Mycoses 2016 Jun;59:334–342.
  • Hsu E, Webster SM, Nanes M. Disseminated cryptococcosis in an immunocompetent host presenting as osteomyelitis and leading to adrenal insufficiency. Am J Med Sci 2022 Jan;363:75–79.
  • Low KT, Peh WC. Magnetic resonance imaging of diabetic foot complications. Singapore Med J 2015 Jan;56:23.
  • Rajasingham R, Wake RM, Beyene T, Katende A, Letang E, Boulware DR. Cryptococcal meningitis diagnostics and screening in the era of point-of-care laboratory testing. J Clin Microbiol 2019 Jan 2;57:e01238–18.
  • Gushiken AC, Saharia KK, Baddley JW. Cryptococcosis. Infect Dis Clin North Am 2021 Jun 1;35:493–514.
  • Gazzoni AF, Severo CB, Salles EF, Severo LC. Histopathology, serology and cultures in the diagnosis of cryptococcosis. Rev Instit Med Trop Sao Paulo 2009;51:255–259.
  • Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ, et al. Clinical practice guidelines for managing cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis 2010 Feb 1;50:291–322.
  • Published: 2023-03-18

    Issue: 2023: Vol 10 No 3 (view)

    Section: Articles

    How to cite:
    Subramony H, Raghavan B, Subbaiyan E, Hegde MG, Ramanathan K. Cryptic presentation of cryptococcal osteomyelitis in an apparently immunocompetent individual. EJCRIM 2023;10 doi:10.12890/2023_003737.