Walia H, Mehta H, Rahi S, Singh I, McKee PH. Beyond the usual suspects - disseminated cryptococcosis presenting as molluscoid skin lesions: A case report. World J Clin Cases 2026; 14(25): 119033 [DOI: 10.12998/wjcc.119033]
Corresponding Author of This Article
Harpreet Walia, Consultant, Head, Department of Pathology, SGHS Sohana Hospital, Sector 77, Mohali 140308, Punjab, India. drhwalia@gmail.com
Research Domain of This Article
Dermatology
Article-Type of This Article
case-report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Harpreet Walia, Department of Pathology, SGHS Sohana Hospital, Mohali 140308, Punjab, India
Hitaishi Mehta, Department of Dermatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160011, India
Sushil Rahi, Department of Neurology, SGHS Sohana Hospital, Mohali 140308, Punjab, India
Inderpreet Singh, Intensive Care Unit, SGHS Sohana Hospital, Mohali 140308, Punjab, India
Phillip H McKee, Department of Surgical Pathology, Brigham and Women’s Hospital, Boston, MA 02115, United States
Co-first authors: Harpreet Walia and Hitaishi Mehta.
Author contributions: Walia H, Mehta H, and Rahi S contributed to the conceptualization of the study; Walia H, Mehta H, Rahi S, and Singh I provided input on the intellectual content, literature search, and clinical studies; Walia H and Rahi S contributed to the manuscript preparation, editing, review, and approval; Walia H contributed to the data acquisition and analyses; Mehta H contributed to the manuscript review and approval; Singh I contributed to the data acquisition, manuscript preparation, review, and approval; McKee PH provided input on intellectual content, and contributed to the manuscript review and approval.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Harpreet Walia, Consultant, Head, Department of Pathology, SGHS Sohana Hospital, Sector 77, Mohali 140308, Punjab, India. drhwalia@gmail.com
Received: January 19, 2026 Revised: February 2, 2026 Accepted: March 27, 2026 Published online: September 6, 2026 Processing time: 228 Days and 18.7 Hours
Abstract
BACKGROUND
Cryptococcosis is an infection caused by Cryptococcus species, an invasive fungus. The fungus is transmitted through the inhalation of spores, and causes opportunistic infection that affects the central nervous system, lungs, and skin. Soil, fruits, wood, and bird excreta commonly harbor the fungus. Two cryptococcal species are known to cause infection in humans. Cryptococcus neoformans is known to affect immunocompromised individuals, whereas C. gattii develops disease in immunocompetent individuals.
CASE SUMMARY
We report a case of disseminated cryptococcosis presenting as molluscoid skin lesions, followed by meningo-encephalitis.
CONCLUSION
Collaboration and communication among interdisciplinary teams is essential in the diagnosis of cryptococcosis. Any nonhealing skin lesion should be biopsied for histopathology. Although cryptococcosis is known to have a high case fatality ratio, in our patient, histopathological examination of skin lesions prompted the timely initiation of therapy, and hence, a favorable outcome was achieved.
Core Tip: Cryptococcal skin lesions are uncommon and may present as erythema, plaque, ulcer or nodule. Very rarely, the skin lesions may present as cellulitis or as molluscoid lesions. Disseminated disease presenting with molluscoid skin lesions is rare. In our patient, lesions presented on the face, many days before clinical onset of meningo-encephalitis. Collaboration and communication among interdisciplinary teams in a healthcare setting can lead to improved patient outcomes. The role of histopathology in the diagnostic process is essential.
