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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        • Global Observatory on Donation and Transplantation (GODT)
        Summary of 2016 activity data.
        (Available at:)
        • Hart A.
        • Smith J.M.
        • Skeans M.A.
        • et al.
        OPTN/SRTR 2017 Annual data report: kidney.
        Am J Transplant. 2019; 19: 19-123
        • Maziarz E.K.
        • Perfect J.R.
        Infect Dis Clin N Am. 2016; 30: 179-206
        • Goldman L.
        • Schafer A.I.
        Goldman’s Cecil Medicine.
        Chapter 344 cryptococcosis. 24th ed. Saunders, Philadelphia2011: 1983-1985
        • Vilchez R.A.
        • Fung J.
        • Kusne S.
        Cryptococcosis in organ transplant recipients: an overview.
        Am J Transplant. 2002; 2: 575-580