All issues > Volume 26(4); 1983

Original Article

J Korean Pediatr Soc. 1983;26(4):315-327. Published online April 30, 1983.

Clinical Study on Cryptococcosis in Children.

Young Min Ahn¹, Hyung Ro Moon¹

¹Department of Pediatrics, College of Medicine，Seoul National University

Abstract

The clinical aspects of childhood cryptococcosis were studied from ten patients admitted to the Pediatric ward of Seoul National University Hospital from January 1976 to December 1981 together with twenty-seven cases of childhood cryptococcosis reported in the Korean literatures. The following results were obtained. 1) The age was distributed between 1 4/12 and 13 5/12 years and males to females ratio was 1.3 ： 1. 2) The common presenting symptoms on admission were fever(81 %), vomiting(49%), abdominal pain(41 %), and headache(38%) and the frequently involved organs were central nervous system(78%), liver(59%), lymph nodes(57%), lung(46%), skin(41 %) and spleen(35%), Eosinophilia was more frequently present in disseminated infection than in the isolated CNS infection. 3) Typical skin lesions were acnelike papules or pustules and molluscum contagiosum like white papules with central umbilication, necrosis and crust which were chiefly distributed on the face, scalp and trunk. Direct smear of skin lesions gave early diagnoses in 4 cases. 4) Cryptococcal infection was confirmed by spinal fluid smear and culture in 22 cases, lymph node biopsy in 15 cases, skin biopsy in 11 cases and liver biopsy in 9 cases. 5) All of the three untreated patients were fatal. With the treatment of Amphotericin B,5-flucytosine or combination therapy, nine cases(35%) died and twenty cases(69%) were improved. 6) In only one case, underlying condition, nephrotic syndrome on the steroid therapy, was present.

Keywords :Cryptococcosis; Skin lesions