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

Gastroenterology. 1984 Jul;87(1):201-3.


Patients with the hyperimmunoglobulin E-recurrent infection (Job's) syndrome, which is characterized by an elevated immunoglobulin 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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amphotericin B / therapeutic use
  • Cryptococcosis / complications*
  • Cryptococcosis / drug therapy
  • Cryptococcosis / microbiology
  • Cryptococcus neoformans / isolation & purification
  • Endoscopy
  • Esophageal Diseases / complications*
  • Esophageal Diseases / drug therapy
  • Esophageal Diseases / microbiology
  • Flucytosine / therapeutic use
  • Humans
  • Job Syndrome / complications*
  • Male
  • Phagocyte Bactericidal Dysfunction / complications*


  • Amphotericin B
  • Flucytosine