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A Case of Cryptococcal Myofascitis in a Patient with Iatrogenic Cushing's Syndrome

의인성 쿠싱 증후군 환자에서 발생한 크립토코쿠스 근육근막염 1예

  • Jung, Ji-Won (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Jun, Mi-Jung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shin, Eun-Hye (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Yang, Young-Joo (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Cho, Hyung-Jin (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Mi-Na (Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Sang-Oh (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 정지원 (울산대학교 의과대학 서울아산병원 내과) ;
  • 전미정 (울산대학교 의과대학 서울아산병원 내과) ;
  • 신은혜 (울산대학교 의과대학 서울아산병원 내과) ;
  • 양영주 (울산대학교 의과대학 서울아산병원 내과) ;
  • 조형진 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김미나 (울산대학교 의과대학 서울아산병원 진단검사의학과) ;
  • 이상오 (울산대학교 의과대학 서울아산병원 내과)
  • Received : 2013.03.22
  • Accepted : 2013.07.02
  • Published : 2014.01.01

Abstract

The skin is the third most common site of cryptococcosis after infections of the central nervous system and lungs. However, cryptococcosis rarely involves deep soft tissue. Here, we report a case of cryptococcal cellulitis and myofascitis in a 72-year-old woman with iatrogenic Cushing's syndrome. Despite the administration of antibiotics, the patient continued to suffer from aggravated wounds and pain. Cultures of pus and an excisional biopsy of the skin revealed Cryptococcus neoformans. She was treated successfully with intravenous fluconazole (400 mg/day) for 14 days followed by oral fluconazole (400 mg/day) for 12 months.

크립토코쿠스에 의한 피부 감염은 비교적 흔하지만 심부 연조직 감염은 매우 드물다. 저자들은 의인성 쿠싱증후군으로 진단된 72세 여자 환자에서 외상 후 Cryptococcus neoformans에 의한 연조직염과 근육근막염을 진단하여 fluconazole을 12개월간 투약 후 호전된 1예를 경험하였기에 문헌고찰과 함께 보고한다.

Keywords

References

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