Disseminated cryptococcosis primarily affects immunosuppressed patients and has a poor outcome if diagnosis and treatment are delayed. Skin lesions are rarely manifest causing misdiagnosis. We present a case of cryptococcal cellulitis with severe pain in a kidney transplant recipient on long-term immunosuppressive therapy. Multiple organs were involved, and there was cutaneous dissemination of the lesions. Histopathology revealed abundant yeast-like cells with wide capsular halos in subcutaneous tissue, suggesting Cryptococcus spp. infection. Laser capture microdissection (LCM)-PCR on skin biopsies confirmed Cryptococcus neoformans var. grubii. A literature review of 17 cases of disseminated cryptococcosis with cutaneous cellulitis or panniculitis in HIV-negative individuals found that over half the patients (52.9%, 9/17) had a history of glucocorticoid therapy, and that the most common site was the legs (76.5%, 13/17). C. neoformans was the main pathogenic species, accounting for 88.2% (15/17) of cases. Fungal cellulitis should be included in the differential diagnosis of cellulitis that fails to respond to antimicrobial therapy in HIV-negative immunosuppressed individuals. Non-culture-based molecular techniques aid in rapid pathogen identification in histologically positive, unculturable specimens.

播散性隐球菌病主要影响免疫抑制患者，如果延误诊断和治疗，预后很差。皮肤病变很少表现出来，导致误诊。我们介绍了一例接受长期免疫抑制治疗的肾移植受者发生隐球菌性蜂窝织炎伴剧烈疼痛的病例。多器官受累，病灶有皮肤播散。组织病理学显示皮下组织中有丰富的酵母样细胞和宽的荚膜晕，表明隐球菌属。感染。皮肤活检的激光捕获显微切割 (LCM)-PCR 证实新型隐球菌变种。格鲁比. 对 17 例 HIV 阴性个体的播散性隐球菌病伴皮肤蜂窝织炎或脂膜炎的文献回顾发现，超过一半的患者（52.9%，9/17）有糖皮质激素治疗史，最常见的部位是腿部。 76.5%，13/17）。新型隐球菌是主要的致病菌种，占病例的88.2%（15/17）。真菌性蜂窝织炎应包括在对 HIV 阴性免疫抑制个体的抗菌治疗无效的蜂窝织炎的鉴别诊断中。非基于培养的分子技术有助于快速鉴定组织学阳性、不可培养的标本中的病原体。