Spastic paraparesis due to cryptococcal osteomyelitis. A case report.

Skeletal cryptococcosis is an uncommon infection. Isolated osteomyelitis due to Cryptococcus neoformans is quite rare. Only seven cases of skeletal cryptococcosis with involvement of vertebrae but no systemic infection have been reported. In only one was there paraplegia. Since vertebral cryptococcosis seems not to have been reported previously in Japan, this case of a 50-year-old coal miner successfully treated for paraparesis caused by cryptococcal spondylitis of the ninth, tenth, and 11th thoracic vertebrae is noteworthy. Two decompression operations and combined amphotericin B and flucytosine therapy reduced the patient's paraparesis, and no sign of recurrence was seen for 21 months after the second operation.