Granulomatous peritoneal cryptococcomas. An unusual sequela of disseminated cryptococcosis.

Abstract

We report an unusual case of fibrosing peritoneal cryptococcal granulomas in a 36-year-old human immunodeficiency virus-negative man with small-bowel obstruction who previously had been treated for cryptococcal meningitis. At laparotomy, multiple pinhead-sized granulomas studded the visceral peritoneum. Microscopic examination showed cryptococcal granulomas characterized by peripheral fibrosis and central caseous necrosis. On mucicarmine staining, the rare teardrop budding and prominent capsular staining were characteristic of Cryptococcus species. We surmise that this inflammatory reaction observed in the peritoneum represents a chronic tissue reaction that occurred during the previous cryptococcal infection.