A Novel Use of the Cryptococcal Latex Agglutination Test for Rapid Presumptive Diagnosis of Cutaneous Cryptococcosis

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Abstract
REPORT OF A CASE The patient, a 35-year-old bisexual man, was positive for the human immunodeficiency virus and was hospitalized with fever, weight loss, and severe abdominal pain. The patient had multiple hypopigmented and flesh-colored 1- to 3-mm papules, many with central umbilication, scattered on his face and neck. Cytologic examination of the material prepared from these lesions, by a variety of techniques described in detail below, suggested a presumptive diagnosis of cutaneous cryptococcosis. Subsequent histologic examination of a skin biopsy specimen showed a dermal mass of fungal organisms with abundant pale capsular material and little evidence of inflammatory reaction; the capsular material stained with mucicarmine (Figure, top). Fungal cultures of the skin biopsy specimen yielded Cryptococcus neoformans. Cryptococcal organisms were also identified in the blood, spinal fluid, and bone marrow specimens and in bronchial washings. Cerebrospinal fluid cryptococcal latex agglutination occurred at a dilution of 1:1024. Fluconazole was administered

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