An unusual cause of obstructive jaundice

Cryptococcus neoformans is an opportunistic fungal infection that mainly affects immunocompromised patients with or without HIV and can only be seen infrequently in the immunocompetent host. Presentation can be with pneumonia, meningitis or widely disseminated disease. We report the case of a 65-year-old man who presented with obstructive jaundice and weight loss. He had been evaluated at another institution where surgery was offered to him for a presumed diagnosis of cholangiocarcinoma. Our evaluation revealed disseminated cryptococcal infection for which the patient received fluconazole for six months, which resulted in the resolution of his obstructive jaundice.