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November 1959

Disseminated Cryptococcosis Producing a Sarcoid Type ReactionThe Report of a Case Treated with Amphotericin B

Author Affiliations

Harrisburg, Pa.

Formerly Resident, Dept. of Internal Medicine, Harrisburg Polyclinic Hospital; at present, a Southeastern Pennsylvania Heart Association Fellow at the Robinette Foundation of Cardiovascular Research at the Hospital of the University of Pennsylvania.

AMA Arch Intern Med. 1959;104(5):763-770. doi:10.1001/archinte.1959.00270110083010

Introduction  Since 1866 when the first case of encephalitis caused by Cryptococcus neoformans was reported by Zenker, there have appeared in the literature about 300 cases of cryptococcosis, 151 cases 1 being reported in the United States alone between 1949 and 1953. The majority of the cases have been of the meningoencephalitic type,2 but in recent years, largely because of improved laboratory techniques, pulmonary involvement, local organ involvement, and granulomatous osteomyelitis caused by Cryptococci have been reported with increased frequency. Whereas localized cryptococcosis is characterized by almost uniform recovery after surgical treatment, the disseminated form of the disease has been almost uniformly fatal, usually terminating with meningitis.At the tissue level, very little inflammatory response is elicited by the conglomerate masses of organisms unless the lesions have been of long duration. Central necrosis in the discrete lesions may occur, but a fibrinous capsule is not usually present.3 Bone

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