The most common presentation of Acquired Immuno-Deficiency Syndrome (AIDS) associated cryptococcosis

is meningitis. Non-meningeal and non-pulmonary Cryptococcosis is very rare. We present a case of

16-year-old boy who presented to the Emergency Department with chief complaints of fever and pain abdomen

involving left hypochondrium for 2 months. On evaluation, he was found to be HIV positive with very

low CD4 count and had splenic abscess along with mesenteric lymphadenopathy. Fine needle aspiration

cytology from the splenic abscess showed scattered multinucleated giant cells containing many rounded

capsulated organisms within the cytoplasm. Alcian Blue-Periodic Acid Schiff stain (AB-PAS) highlighted the

capsulated organisms as Cryptococcus neoformans. The patient was treated successfully with liposomal

amphotericin B and flucytosine, followed by fluconazole along with antiretroviral therapy.