A Rare Case of Primary Supraclavicular Lymphadenitis due to Cryptococcus Neoformans in an HIV Infected Patient

J Clin Diagn Res. 2014 Feb;8(2):137-8. doi: 10.7860/JCDR/2014/6346.4031. Epub 2014 Feb 3.

Abstract

Cryptococcosis caused by encapsulated yeast Cryptococcus neoformans most commonly presents as disease of the central nervous system. Cryptococcus is a non-mycelial budding yeast found in soil, pigeon droppings and their nesting places. The three 'classic' virulence factors of cryptococci are: polysaccharide capsule, melanin production and growth at 37°C. Here, we present a rare case of cryptococcosis affecting left supraclavicular lymph node in a Human Immunodeficiency virus (HIV) infected individual. Culture of fine needle aspirate of the lymph node yielded Cryptococcus neoformans which was identified by standard microbiological techniques. Meyer's mucicarmine stain imparted a typical rose burgundy colour to the capsule. Unusual characteristics of the isolate included poorly developed capsule and the presence of yeast in chains resembling pseudo-hyphae. This case highlights the importance of microbiological techniques for diagnosis and prompt treatment of cryptococcosis.

Keywords: Cryptococcus neoformans; Hypocapsular variant; Lymph node.

Publication types

  • Case Reports