Hepatic Failure as a Manifestation of Cryptococcosis

Abstract

Cryptococcosis, a systemic fungus infection caused by Cryptococcus neoformans , most commonly involves the central nervous system, 1 lungs, 2 skin, 3 and bones. 4 Almost every tissue can be affected when the fungus is disseminated; however, only occasionally are such infections clinically significant. In rare instances, involvement of adrenal glands, 5,6 cardiovascular system, gastrointestinal tract, or genitourinary system may lead to organ dysfunction or failure. 1 Histologic evidence of hepatic involvement in disseminated cryptococcosis has been previously reported 7-10 ; however, in these instances there was no evidence that intrahepatic fungal proliferation had interfered with liver function. The present paper is a report of two patients in whom hepatic failure was most likely caused by intrahepatic cryptococcosis. One patient, with Hodgkin's disease and disseminated cryptococcosis, developed hepatic failure as the terminal event in her illness. Microscopic examination disclosed hepatic necrosis associated with cryptococcosis without evidence of other liver disease. The second