Cryptococcal immune reconstitution inflammatory syndrome: Cutaneous clues to disseminated cryptococcosis in a human immunodeficiency virus patient coinfected with tuberculosis on antiretroviral therapy.

Abstract

A 21-year-old female patient, diagnosed with human immunodeficiency virus (HIV) in 2020 on highly active antiretroviral therapy and antitubercular therapy for 2 months for pulmonary tuberculosis, presented with multiple skin-colored umbilicated papules all over the face and body, accompanied by severe headache and cough with expectoration for the past 10 days. Needling of the lesions yielded serous discharge. Subsequent investigations, including biopsy, cerebrospinal fluid analysis, and stool examination, confirmed the presence of Cryptococcus. A lumbar puncture was performed to alleviate increased intracranial pressure. Although cryptococcal infections are prevalent among HIV individuals, prompt diagnosis is essential to reduce the mortality risk.