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Case of the Month - March 2020

Cryptococcal necrotizing soft tissue infections in solid organ transplants
Questions

  1. Type II necrotizing fasciitis has been reported to be caused by which of the following organisms?
    1. Enteric Gram-negatives in association with anaerobes
    2. Streptococcus pyogenes
    3. Clostridium perfringens
    4. Staphylococcus aureus
  2. What disorders are associated with invasive cryptococcal disease?
    1. Haematological malignancies
    2. Sarcoidosis
    3. Solid organ transplantation
    4. All of the above
  3. What are the main virulence factors of Cryptococcus neoformans species-complex?
    1. Lipopolysaccharide
    2. Polysaccharide capsule production
    3. Beta-D-Glucan
    4. Melanin production

Figure 1: Gram stain of surgically debrided fascia demonstrating irregularly staining round-oval yeast cells

Figure 2: Growth of Cryptococcus neoformans on 2% blood agar after overnight incubation aerobically at 37⁰C


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