Hidden in plain sight: urinary Cryptococcus neoformans missed by routine diagnostics in a patient with acute leukemia

  • Zoe F. Weiss (Creator)
  • James E. DiCarlo (Creator)
  • David W. Basta (Creator)
  • Stephanie Kent (Creator)
  • Alexis Liakos (Creator)
  • Lindsey R. Baden (Creator)
  • Manfred Brigl (Creator)
  • Sanjat Kanjilal (Creator)
  • Connie F. Cañete-Gibas (Creator)
  • Nathan Wiederhold (Creator)
  • Sankha S. Basu (Creator)



Abstract Cryptococcuria is a rare manifestation of localized cryptococcal disease. We present a case of Cryptococcus neoformans urinary tract infection in an immunocompromised host missed by routine laboratory workup. The patient had negative blood cultures, a negative serum cryptococcal antigen (CrAg), and “non-Candida yeast” growing in urine culture that was initially dismissed as non-pathogenic. The diagnosis was ultimately made by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) from a repeat urine culture after transfer to a tertiary care center. Cryptococcus should be considered in the differential of refractory urinary tract infections growing non-Candida yeast.
Date made available2022

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