Esophageal cryptococcosis in a patient with the hyperimmunoglobulin E-recurrent infection (Job's) syndrome

David H. Jacobs, Abe M. Macher, Richard Handler, John E. Bennett, Martin J. Collen, John I. Gallin

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Abstract

Patients with the hyperimmunoglobulin E-recurrent infection (Job's) syndrome, which is characterized by an elevated immunoglobuin E level, recurrent staphylococcal infections, and an abnormality of neutrophil chemotaxis, have been reported to have visceral Candida infections in addition to their more frequent pyogenic infections. We report a patient with Job's syndrome who presented with massive hematemesis secondary to esophageal cryptococcosis. A thorough evaluation for an occult neoplasm or extraesophageal cryptococcosis was negative. The patient received a 6-wk course of amphotericin B (970 mg) and 5-fluorocytosine with complete radiographic and endoscopic resolution of the lesion. He is doing well 18 mo after therapy. The patient was not anergic, and his response to T-cell mitogens, helper-to-suppressor T-cell ratio, total number of T cells, and immunoglobulin-producing capability were all normal. This case is unusual in that it is the first documentation of a cryptococcoma of the esophagus and underscores the importance of culturing abnormal specimens for unsuspected pathogens in unusual clinical circumstances.

Original languageEnglish (US)
Pages (from-to)201-203
Number of pages3
JournalGastroenterology
Volume87
Issue number1
StatePublished - Jul 1984

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ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Jacobs, D. H., Macher, A. M., Handler, R., Bennett, J. E., Collen, M. J., & Gallin, J. I. (1984). Esophageal cryptococcosis in a patient with the hyperimmunoglobulin E-recurrent infection (Job's) syndrome. Gastroenterology, 87(1), 201-203.