Placental cryptococcosis in a mother with systemic lupus erythematosus.

There are many pregnant mothers who have acquired immunodeficiency syndrome or who require immunosuppressive therapy for sundry reasons. Despite this, we have been able to find only one English-language report of placental cryptococcosis. We have had an opportunity to treat a pregnant mother who suffered from cryptococcal meningitis that complicated steroid treatment for lupus erythematosus. At 31 weeks' gestation, fetal distress necessitated delivery by cesarean section. The placenta had focally abundant intervillous and perivillous cryptococcal yeast cells, but there was no chorioamnionitis or villitis. Although there were no clinical or placental signs of transplacental infection, immunohistochemical labeling of villous stromal cells showed a conspicuously increased number of fetal macrophages.