���身性エリテマトーデス治療中に致死的経過を辿った播種性クリプトコックス症の1例

A 62-year-old female patient under long-term corticosteroid therapy for systemic lupus erythematosus consulted our hospital for generalized malaise and was subsequently admitted to the hospital with the diagnosis of prerenal renal failure. During hospitalization, right lateral abdominal erythema and an elevated serum C-reactive protein level were observed. Chest computed tomography showed multiple nodular shadows in the right upper lung lobe. Thereafter, Cryptococcus neoformans was isolated from the blood and skin biopsy samples obtained from the erythematous region in the right lateral abdomen. Based on the findings, we established the diagnosis of disseminated cryptococcosis. Although the patient was immediately initiated on antifungal treatments, she developed cerebral infarction and pancreatitis, which were possibly attributed to the disseminated cryptococcosis. Subsequently, she rapidly developed evidence of disseminated intravascular coagulation syndrome and multiple organ failure, resulting in death. Herein, we report a case of disseminated cryptococcosis, in which detailed microbiological and pathological analysis was conducted.