Site Under Construction

Molluscum contagiosum-like lesions: a telltale sign of disseminated cryptococcosis (RITM)

Authors: Audi, MD, Emmerson Gale S. Vista, MD, FPDS,, Marie Claudine Francesca B. Perlas, MD, DPDS, Lunardi Bintanjoyo, MD1, Johannes F. Dayrit MD, FPDS, FDSP


Introduction: Cryptococcosis is an opportunistic fungal infection caused by Cryptococcus neoformans. This systemic fungal infection affects 6 to 13% of patients with acquired immunodeficiency syndrome (AIDS). Only 10% of patients with this condition develop cutaneous manifestations.

Case Summary: A 20-year-old male, newly diagnosed case of HIV (Human Immunodeficiency Virus), presented with multiple skin-colored molluscum contagiosum-like umbilicated papules on the face, neck and both arms. Lesions increased in number rapidly and were associated with respiratory distress. Histopathologic examination revealed findings of opportunistic fungal infection suggestive of cryptococcosis. Serum Cryptococcal Antigen Latex Agglutination System (CALAS) test was also positive. Patient was then diagnosed as a case of cryptococcosis and was a candidate for intravenous amphotericin B. However, before the planned medication was given, the patient experienced severe respiratory distress and expired several hours later.

Conclusion: Molluscum-like skin lesions may be a telltale sign of a disseminated opportunistic fungal infection, including Cryptococcosis. Early diagnosis followed by prompt and aggresive treatment would improve outcome and survival of the patient. 


Cryptococcosis, AIDS, HIV

1. Murakawa.G.J, Kerschmann. R, Berger T. Cutaneous Cryptococcus Infection and AIDS. Report of 12 cases and review of literature. Arch dermatol 1996; 132(5):545-8.

2. Nnoruka EN, Chukwuka JC, Anisuiba B: Correlation of mucocutaneous manifestations of HIV/AIDS infection with CD4 counts and disease progression. Int J Dermatol 46(Suppl.2):14-18, 2007

3. Joseph. G. Ogbaini-Emovon. E, et al. Prevalence of Disseminated Cryptococcosis among Human Immunodeficiency Virus Infected Patients in Benin City, Nigeria. British Journal of Medicine and Medical research. 2015;6(7):715-22.

4. Srivastava.G.N, Tilak.R, Yadav.J, Bansal.M. Cutaneous Cryptococcus: marker for disseminated infection. BMJ Case Rep. 2015. doi:10.1136/bcr2015210898.

5. Chan.M, Lye.D. Clinical and microbiological characteristics of cryptococcosis in Singapore: predominance of Cryptococcus neoformans compared with Cryptococcus gattii. International Journal of Infectious Diseases. 2014;26:110-5.

6. Dimino-Emme L, Gurevitch AW: Cutaneous manifestations of disseminated cryptococcosis. J Am Acad Dermatol 32(5 Pt 2):844-850,1995

7. Rapini.R.P. Fungal Diseases. In: Rapini.R.P. editor. Practical Dermatopathology. 2nd ed. USA Elsevier Inc; 2012, p 192.

8. Saldanha Dominic.R.M, Prashanth.H.V, et al. Diagnostic Value of Latex Agglutination in Cryptococcal Meningitis. Journal of Laboratory Physicians. 2009;1(2):67-8

9. Anekthananon.T, Manosuthi.W, et al. Predictors of poor clinical outcome of cryptococcal meningitis in HIV-infected patients. International Journal STD AIDS. 2011;22(11):665-70

10. Perfect JR, Dismukes WE, Dromer F, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of america. Clin Infect Dis 2010; 50(3): 291-322.

More Articles


REquesting Permission

Molluscum contagiosum-like lesions: a telltale sign of disseminated cryptococcosis (RITM)