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Cryptococcal Abscess Imitating a Soft-Tissue Sarcoma in an Immunocompetent HostA Case Report
Trevor Gaskill, MD1; Diane Payne, MD1; Brian Brigman, MD, PhD1
1 Division of Orthopaedic Surgery, Duke Medical Center, DUMC Box 3000 (T.G. and D.P.) and 3312 (B.B.), Durham, NC 27710. E-mail address for T. Gaskill: gaski011@mc.duke.edu
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at the Division of Orthopaedic Surgery, Duke Medical Center, Durham, North Carolina

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Aug 04;92(9):1890-1893. doi: 10.2106/JBJS.I.01091
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Cryptococcus neoformans is a ubiquitous encapsulated yeast found throughout the world. Although it is only occasionally a pathogen in immunocompetent hosts, it emerged in the 1980s as an important opportunistic infection in patients with acquired immunodeficiency syndrome. Infection typically begins in the lungs and can disseminate, causing central nervous system dysfunction, cutaneous manifestations, and, occasionally, osteomyelitis in up to 10% of cases1,2. Noncutaneous cryptococcal abscesses in an immunocompetent host are exceedingly rare, and, to our knowledge, a soft-tissue cryptococcal abscess in an immunocompetent host has not been previously reported. We present the successful treatment of an isolated cryptococcal abscess, initially thought to be a soft-tissue sarcoma, in an immunocompetent host. The case of our patient adds to the current treatment literature and highlights the importance of having a tissue diagnosis prior to surgical intervention. The patient was informed that data concerning the case would be submitted for publication, and he consented.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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