Cryptococcus neoformans infection in a post-operative mastoid cavity of an immunocompetent individual: a rare case report

Rahul S. Gosavi, Akash D. Gupta, Shishir D. Gosavi, Jayanti U. Phatak


This is a case report of isolated cryptococcosis in the operated mastoid cavity of an immunocompetent individual. A 24 year old immunocompetent male who underwent modified radical mastoidectomy presented to the OPD with complaints of otalgia and recurrent otorrhoea, not responding to regular medical line of treatment and aural toileting. Microscopy and culture of the ear dischrage revealed Cryptococcus neoformans. The patient was treated with oral and topical fluconazole and recovered completely. Although rare, cryptococcal mastoiditis should be considered even in an immunocompetent patient, as any delay in diagnosis and treatment can lead to fatal complications.


Cryptococcosis, Cryptococcal mastoiditis, Fluconazole, Immunocompetent host, Fungal mastoiditis

Full Text:



Roden D, Honrubia VF, Wiet R. Outcome of residual cholesteatoma and hearing in mastoid surgery. J Otolaryngol. 1996;25(3):178-81.

Khalil HS, Windle-Taylor PC. Canal wall down mastoidectomy: A long term commitment to the outpatients?. BMC Ear Nose Throat Disord. 2003;3(1):1.

Dutta HD, Rayamajhi P, Dutta D.Modified radical mastoidectomy in children: mastoid cavity problem and its management. Int J Otorhinolaryngol Head Neck Surg. 2019;5:1156-60.

Sheehy JL, House HP. Dry Treatment of Infected Mastoid Cavities. AMA Arch Otolaryngol. 1959;70(4):509-10.

Gray RF, Sharma A, Vowler SL. Relative humidity of the external auditory canal in normal and abnormal ears, and its pathogenic effect. Clin Otolaryngol. 2005;30(2):105-11.

Ohki M, Ito K, Ishimoto S. Fungal mastoiditis in an immunocompetent adult. Eur Arch Otorhinolaryngol. 2001;258(3):106-8.

Varghese R, Nair RM, Kavalakkat FJ. Fungal otomastoiditis: a case series in immunocompetent adults. Indian J Otolaryngol Head Neck Surg. 2014;66(1):110-3.

Pappas PG, Perfect JR, Cloud GA, Larsen RA, Pankey GA, Lancaster DJ, et al. Cryptococcosis in human immunodeficiency virus-negative patients in the era of effective azole therapy. Clin Infect Dis. 2001;33(5):690-9.

Corral JE, Lima S, Quezada J, Samayoa B, Arathoon E. Cryptococcal osteomyelitis of the skull. Med Mycol. 2011;49(6):667-71.

Casadevall A. Cryptococcosis. In: Jameson L, Fauci A, Kasper D, Hauser S, Longo D, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 20th ed. New York: Mcgraw Hill; 2018: 1528.