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Behind the Leg: Cryptococcal Meningitis, Not Cellulitis

      A 70-year-old woman was referred because of persistent fever and redness and swelling on her left leg for 2 months. She was initially diagnosed with cellulitis of the left leg by her previous doctor and was treated with several courses of oral cefotiam, cefdinir, and levofloxacin; however, her leg lesion did not subside. During the treatment, she also developed a mild headache, nausea, and loss of appetite. She had undergone living donor kidney transplantation from her husband 8 years previously due to chronic glomerulonephritis. Cytomegalovirus retinitis developed within 1 year of the transplantation; otherwise, her condition had remained stable with tacrolimus, mycophenolate mofetil, and methylprednisolone treatment. Her medical history also included steroid-induced diabetes mellitus, osteoporosis, hypertension, appendectomy, total abdominal hysterectomy, and bilateral salpingo-oophorectomy for uterine myoma. She never smoked, occasionally drank, and did not use illicit drugs.
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