A Trespasser in Lymph Node: A Case Report.

Cryptococcal meningitis is a prevalent, opportunistic fungal disease seen in human immunodeficiency virus (HIV)-infected individuals. A lymph node is an unusual presentation site for Cryptococcus and can mimic tuberculosis. Disseminated cryptococcosis is a life-threatening disease that is seen commonly in acquired immunodeficiency syndrome (AIDS). We report a case of an HIV patient who presented with mild pleural effusion, multiple mediastinal, axillary lymphadenopathy with a low CD4:CD8 lymphocyte ratio, and favored clinically disseminated tuberculosis. Further cerebrospinal fluid (CSF) and tracheal aspirate have been done. Tracheal aspirate culture shows a fungal organism resembling Cryptococcus. Later, India ink staining on CSF highlighted the fungal organism Cryptococcus. Cytopathological investigation showed necrotizing inflammation along with fungal organisms, confirming the presence of cryptococcal lymphadenitis.