{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T17:30:20Z","timestamp":1787679020911,"version":"build-2784847793"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Cryptococcal osteomyelitis is a rare and potentially serious condition, typically encountered in individuals with compromised immune systems. This case underscores the unusual occurrence of disseminated Cryptococcosis in an immunocompetent person, involving multiple bones and lungs, with\n                      <jats:italic>Cryptococcus neoformans<\/jats:italic>\n                      identified as the causative agent.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      An Indonesian man, previously in good health, presented with a chief complaint of successive multiple bone pain lasting for more one month, without any prior history of trauma. Additionally, he reported a recent onset of fever. On physical examination, tenderness was observed in the left lateral chest wall and right iliac crest. Laboratory findings indicated mildly elevated inflammatory markers. A computed tomography (CT) scan of the chest revealed an ovoid solid nodule in the right lower lung and multifocal osteolytic lesions in the sternum, ribs, and humeral head. A magnetic resonance imaging (MRI) study of the sacrum showed multiple lesions in the bilateral iliac bone and the lower L4 vertebral body. Confirmation of Cryptococcal osteomyelitis involved a fine-needle biopsy and culture, identifying\n                      <jats:italic>Cryptococcus neoformans<\/jats:italic>\n                      in the aspirate. The patient responded positively to targeted antifungal treatments, leading to a gradual improvement in his condition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This case emphasizes the need to consider\n                      <jats:italic>Cryptococcus neoformans<\/jats:italic>\n                      osteomyelitis in immunocompetent patients with bone pain. A definitive diagnosis involves a fine-needle biopsy for pathology and culture, and prompt initiation of appropriate antifungal treatment has proven effective in preventing mortality.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-024-09264-6","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T09:01:53Z","timestamp":1712912513000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Disseminated Cryptococcus neoformans infection involving multiple bones and lung in an immunocompetent patient: a case report"],"prefix":"10.1186","volume":"24","author":[{"given":"Yang-Ming","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuag-Meng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung-Chia","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,12]]},"reference":[{"issue":"1","key":"9264_CR1","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.idc.2015.10.006","volume":"30","author":"EK Maziarz","year":"2016","unstructured":"Maziarz EK, Perfect JR, Cryptococcosis. Infect Dis Clin N Am. 2016;30(1):179\u2013206.","journal-title":"Infect Dis Clin N Am"},{"issue":"3","key":"9264_CR2","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1513\/pats.200907-063AL","volume":"7","author":"SS Li","year":"2010","unstructured":"Li SS, Mody CH, Cryptococcus. Proc Am Thorac Soc. 2010;7(3):186\u201396.","journal-title":"Proc Am Thorac Soc"},{"issue":"7","key":"9264_CR3","doi-asserted-by":"publisher","first-page":"751","DOI":"10.3109\/13693786.2012.670277","volume":"50","author":"Y Zhang","year":"2012","unstructured":"Zhang Y, Yu YS, Tang ZH, Zang GQ. Cryptococcal osteomyelitis of the scapula and rib in an immunocompetent patient. Med Mycol. 2012;50(7):751\u20135.","journal-title":"Med Mycol"},{"issue":"7","key":"9264_CR4","doi-asserted-by":"publisher","first-page":"a019760","DOI":"10.1101\/cshperspect.a019760","volume":"4","author":"KJ Kwon-Chung","year":"2014","unstructured":"Kwon-Chung KJ, Fraser JA, Doering TL, Wang Z, Janbon G, Idnurm A, et al. Cryptococcus neoformans and Cryptococcus gattii, the etiologic agents of cryptococcosis. Cold Spring Harbor Perspect Med. 2014;4(7):a019760.","journal-title":"Cold Spring Harbor Perspect Med"},{"issue":"1","key":"9264_CR5","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s40249-023-01073-4","volume":"12","author":"Y Zhao","year":"2023","unstructured":"Zhao Y, Ye L, Zhao F, Zhang L, Lu Z, Chu T, et al. Cryptococcus neoformans, a global threat to human health. Infect Dis Poverty. 2023;12(1):20.","journal-title":"Infect Dis Poverty"},{"issue":"4","key":"9264_CR6","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1128\/CMR.00126-13","volume":"27","author":"SC Chen","year":"2014","unstructured":"Chen SC, Meyer W, Sorrell TC. Cryptococcus gattii infections. Clin Microbiol Rev. 2014;27(4):980\u20131024.","journal-title":"Clin Microbiol Rev"},{"key":"9264_CR7","unstructured":"Mada PK, Jamil RT, Alam MU, Cryptococcus. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Radia Jamil declares no relevant financial relationships with ineligible companies. Disclosure: Mohammed Alam declares no relevant financial relationships with ineligible companies.: StatPearls Publishing Copyright \u00a9 2024. StatPearls Publishing LLC.; 2024."},{"issue":"5","key":"9264_CR8","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1007\/s15010-007-6109-9","volume":"35","author":"JA Al-Tawfiq","year":"2007","unstructured":"Al-Tawfiq JA, Ghandour J. Cryptococcus neoformans abscess and osteomyelitis in an immunocompetent patient with tuberculous lymphadenitis. Infection. 2007;35(5):377\u201382.","journal-title":"Infection"},{"issue":"6","key":"9264_CR9","doi-asserted-by":"publisher","first-page":"1034","DOI":"10.1227\/00006123-199306000-00028","volume":"32","author":"RA Armonda","year":"1993","unstructured":"Armonda RA, Fleckenstein JM, Brandvold B, Ondra SL. Cryptococcal skull infection: a case report with review of the literature. Neurosurgery. 1993;32(6):1034\u20136. discussion 6.","journal-title":"Neurosurgery"},{"issue":"9","key":"9264_CR10","doi-asserted-by":"publisher","first-page":"669","DOI":"10.3855\/jidc.1352","volume":"5","author":"I Qadir","year":"2011","unstructured":"Qadir I, Ali F, Malik UZ, Umer M. Isolated cryptococcal osteomyelitis in an immunocompetent patient. J Infect Developing Ctries. 2011;5(9):669\u201373.","journal-title":"J Infect Developing Ctries"},{"issue":"2","key":"9264_CR11","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1093\/cid\/ciab920","volume":"75","author":"PH Kuo","year":"2022","unstructured":"Kuo PH, Wu UI, Pan YH, Wang JT, Wang YC, Sun HY, et al. Neutralizing anti-granulocyte-macrophage colony-stimulating factor autoantibodies in patients with Central Nervous System and localized cryptococcosis: Longitudinal Follow-Up and Literature Review. Clin Infect Diseases: Official Publication Infect Dis Soc Am. 2022;75(2):278\u201387.","journal-title":"Clin Infect Diseases: Official Publication Infect Dis Soc Am"},{"issue":"1","key":"9264_CR12","doi-asserted-by":"publisher","first-page":"828","DOI":"10.1186\/s12879-020-05553-y","volume":"20","author":"M Roerden","year":"2020","unstructured":"Roerden M, D\u00f6ffinger R, Barcenas-Morales G, Forchhammer S, D\u00f6bele S, Berg CP. Simultaneous disseminated infections with intracellular pathogens: an intriguing case report of adult-onset immunodeficiency with anti-interferon-gamma autoantibodies. BMC Infect Dis. 2020;20(1):828.","journal-title":"BMC Infect Dis"},{"issue":"9","key":"9264_CR13","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1038\/nm.4158","volume":"22","author":"CH Lin","year":"2016","unstructured":"Lin CH, Chi CY, Shih HP, Ding JY, Lo CC, Wang SY, et al. Identification of a major epitope by anti-interferon-\u03b3 autoantibodies in patients with mycobacterial disease. Nat Med. 2016;22(9):994\u20131001.","journal-title":"Nat Med"},{"issue":"8","key":"9264_CR14","doi-asserted-by":"publisher","first-page":"1357","DOI":"10.1182\/blood-2012-08-452482","volume":"121","author":"CY Chi","year":"2013","unstructured":"Chi CY, Chu CC, Liu JP, Lin CH, Ho MW, Lo WJ, et al. Anti-IFN-\u03b3 autoantibodies in adults with disseminated nontuberculous mycobacterial infections are associated with HLA-DRB1*16:02 and HLA-DQB1*05:02 and the reactivation of latent varicella-zoster virus infection. Blood. 2013;121(8):1357\u201366.","journal-title":"Blood"},{"key":"9264_CR15","doi-asserted-by":"crossref","unstructured":"Patel SY, Ding L, Brown MR, Lantz L, Gay T, Cohen S et al. Anti-IFN-gamma autoantibodies in disseminated nontuberculous mycobacterial infections. Journal of immunology (Baltimore, Md: 1950). 2005;175(7):4769-76.","DOI":"10.4049\/jimmunol.175.7.4769"},{"key":"9264_CR16","doi-asserted-by":"publisher","first-page":"105","DOI":"10.3389\/fmicb.2016.00105","volume":"7","author":"CM Leopold Wager","year":"2016","unstructured":"Leopold Wager CM, Hole CR, Wozniak KL, Wormley FL. Jr. Cryptococcus and phagocytes: complex interactions that Influence Disease Outcome. Front Microbiol. 2016;7:105.","journal-title":"Front Microbiol"},{"issue":"4","key":"9264_CR17","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1016\/j.mib.2013.03.006","volume":"16","author":"O Zaragoza","year":"2013","unstructured":"Zaragoza O, Nielsen K. Titan cells in Cryptococcus neoformans: cells with a giant impact. Curr Opin Microbiol. 2013;16(4):409\u201313.","journal-title":"Curr Opin Microbiol"},{"issue":"6","key":"9264_CR18","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/myc.12476","volume":"59","author":"LA Medaris","year":"2016","unstructured":"Medaris LA, Ponce B, Hyde Z, Delgado D, Ennis D, Lapidus W, et al. Cryptococcal osteomyelitis: a report of 5 cases and a review of the recent literature. Mycoses. 2016;59(6):334\u201342.","journal-title":"Mycoses"},{"key":"9264_CR19","first-page":"740","volume":"5","author":"HX Zhou","year":"2014","unstructured":"Zhou HX, Lu L, Chu T, Wang T, Cao D, Li F, et al. Skeletal cryptococcosis from 1977 to 2013. Front Microbiol. 2014;5:740.","journal-title":"Front Microbiol"},{"issue":"1","key":"9264_CR20","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/S0732-8893(97)00190-9","volume":"30","author":"PY Liu","year":"1998","unstructured":"Liu PY. Cryptococcal osteomyelitis: case report and review. Diagn Microbiol Infect Dis. 1998;30(1):33\u20135.","journal-title":"Diagn Microbiol Infect Dis"},{"issue":"1","key":"9264_CR21","first-page":"e21074","volume":"14","author":"A Dumenigo","year":"2022","unstructured":"Dumenigo A, Sen M. Cryptococcal osteomyelitis in an Immunocompetent patient. Cureus. 2022;14(1):e21074.","journal-title":"Cureus"},{"issue":"1","key":"9264_CR22","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1186\/s12879-023-08066-6","volume":"23","author":"Y Zhong","year":"2023","unstructured":"Zhong Y, Huang Y, Zhang D, Chen Z, Liu Z, Ye Y. Isolated cryptococcal osteomyelitis of the sacrum in an immunocompetent patient: a case report and literature review. BMC Infect Dis. 2023;23(1):116.","journal-title":"BMC Infect Dis"},{"issue":"19","key":"9264_CR23","doi-asserted-by":"publisher","first-page":"6617","DOI":"10.12998\/wjcc.v10.i19.6617","volume":"10","author":"JL Ma","year":"2022","unstructured":"Ma JL, Liao L, Wan T, Yang FC. Isolated cryptococcal osteomyelitis of the ulna in an immunocompetent patient: a case report. World J Clin Cases. 2022;10(19):6617\u201325.","journal-title":"World J Clin Cases"},{"issue":"5","key":"9264_CR24","doi-asserted-by":"publisher","first-page":"815","DOI":"10.1159\/000328567","volume":"44","author":"DA Witte","year":"2000","unstructured":"Witte DA, Chen I, Brady J, Ramzy I, Truong LD, Ostrowski ML. Cryptococcal osteomyelitis. Report of a case with aspiration biopsy of a humeral lesion with radiologic features of malignancy. Acta Cytol. 2000;44(5):815\u20138.","journal-title":"Acta Cytol"}],"container-title":["BMC Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09264-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12879-024-09264-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12879-024-09264-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T09:01:59Z","timestamp":1712912519000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcinfectdis.biomedcentral.com\/articles\/10.1186\/s12879-024-09264-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,12]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["9264"],"URL":"https:\/\/doi.org\/10.1186\/s12879-024-09264-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3849410\/v1","asserted-by":"object"}]},"ISSN":["1471-2334"],"issn-type":[{"value":"1471-2334","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,12]]},"assertion":[{"value":"10 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 April 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors read and approved the final manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Informed consent for publication was obtained from the patient.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The authors declare that they have no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"397"}}