Unveiling bone marrow cryptococcosis in an immunocompetent child: A rare case presentation

Cryptococcal infection is less common in immunocompetent hosts and almost always occurs in the setting of HIV disease. Disseminated Cryptococcosis in a child is a fatal condition and often requires a prompt diagnosis and appropriate antifungal therapy to improve patient outcomes. Here, we present a case of bone marrow Cryptococcal infection in a 4-year-old female child. She presented clinically with fever, abdominal pain, and hepatosplenomegaly for a duration of two and a half months. A bone marrow aspiration and trephine biopsy was performed with a suspicion of haemato-lymphoid malignancy. However, bone marrow aspirate smears revealed bone marrow Cryptococcosis which was later confirmed by special stains. She was treated with liposomal amphotericin B (3 mg/kg) and flucytosine (100 mg/kg/day). A comprehensive approach including clinical symptoms, examination findings, imaging studies, and laboratory tests is crucial in establishing an early diagnosis of Cryptococcosis, particularly with atypical presentations.