Sepsis syndrome is a rare manifestation of cryptococcosis and occurs almost exclusively in HIV-infected patients. Fever is followed by respiratory distress and multiorgan system disease. This syndrome is often fatal. Cutaneous disease may accompany disseminated cryptococcosis or local infection. Early lesions are erythematous, may be single or multiple, and are variably indurated and tender.
Lesions often become ulcerated with central necrosis and raised borders.
Cutaneous cryptococcosis in HIV-infected patients may resemble molluscum contagiosum. The onset of symptoms is insidious and chronic. Bony involvement is typified by soft tissue swelling and tenderness, and arthritis is characterized by effusion, erythema, and pain on motion. The vertebrae are the most common sites of infection followed by the tibia, ileum, rib, femur, and humerus. Concomitant bone and joint disease results from contiguous spread.