Disseminated Cryptococcosis with Duodenal and Lymph Node Involvement in an Patient with AIDS: An Unusual Case Report

Abstract

Cryptococcosis is a prevalent opportunistic infection in patients with advanced immunosuppression, although its extrapulmonary non-meningeal forms remain infrequent and poorly characterized. We present the case of a patient with AIDS who developed disseminated cryptococcosis with pulmonary, meningeal, lymph node, and duodenal involvement, the latter two being exceptionally reported manifestations. The diagnosis was confirmed through microbiological, radiological, and histopathological studies, and treatment required an induction regimen with amphotericin B followed by consolidation and maintenance with fluconazole, in a regional context where flucytosine is not available. This case underscores the importance of recognizing atypical presentations, considering dissemination in patients with gastrointestinal symptoms or lymphadenopathy, and highlights the need to generate local evidence and specific guidelines for these uncommon forms.