Multifocal Cryptococcus Neoformans Osteomyelitis in a Kidney Transplant Recipient

Cryptococcal infections are notoriously difficult to diagnose and have been associated with high morbidity and mortality. Cryptococcus neoformans presenting as osteomyelitis is an unexpected clinical scenario in the transplant ward. A young male who underwent spousal kidney donor transplantation 16 months ago presented with painful and ulcerated soft tissue in upper and lower limbs which were diagnosed as cryptococcus osteomyelitis. He was managed with surgical debridement, liposomal amphotericin B, flucytosine and reduction in maintenance immunosuppression (IS). To our knowledge this is the first reported case of multifocal cryptococcus osteomyelitis in a kidney transplant recipient.