Bilateral otomastoiditis caused by Cryptococcus neoformans, a rare manifestation in patient with adult-onset immunodeficiency due to anti-interferon-γ autoantibodies.

Cryptococcus is an opportunistic fungal pathogen found in immunocompromised patient such as HIV or transplant recipients. Infection of central nervous system is the most common manifestation but pulmonary and skeletal involvement have been reported in non-HIV population. We report a case of cryptococcal otomastoiditis which was extremely rare and majority of cases were reported in individual without comorbidity. In this case, we also identified adult-onset immunodeficiency associated with interferon-gamma autoantibodies in this patient as an important underlying which predisposed cryptococcal infection.