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Critical Situations
January 2006

Tzanck Smear as a Rapid Diagnostic Tool for Disseminated Cryptococcal Infection

Arch Dermatol. 2006;142(1):25-27. doi:10.1001/archderm.142.1.25

A 60-year-old African American man presented with a 3-week history of multiple pruritic lesions on his face, neck, and scalp. Approximately 1 year earlier, he had undergone a bilateral cadaveric renal transplantation. His medical history was significant for chronic hypertension, diabetes mellitus with retinopathy and neuropathy, hepatitis C, chronic hepatitis B, and hepatitis A that had resolved. Since the transplantation, he had been receiving immunosuppressive therapy, which included tacrolimus (1 mg/d), mycophenolate mofetil (750 mg twice a day), and prednisone (10 mg/d). He denied any systemic symptoms, such as cough, pain, headache, fever, confusion, or shortness of breath, but his vision had been blurry for 3 to 4 weeks before presentation. He was taking no antifungal agents.