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cryptococcosis

Wednesday 14 March 2007

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- pulmonary cryptococcosis

- cutaneous cryptococcosis

Definition: Infection by Cryptococcus neoformans.

Cryptococcosis, or cryptococcal disease, is a potentially fatal fungal disease.

It is caused by members of the Cryptococcus neoformans species complex, comprising the three variants C. neoformans v. gattii (Cryptococcus gattii), C. neoformans v. neoformans, and C. neoformans v. grubii.

Cryptococcosis is believed to be acquired by inhalation of the infectious propagule from the environment. Although the exact nature of the infectious propagule is unknown, the leading hypothesis is the basidiospore created through sexual or asexual reproduction.

Cryptococcosis is a defining opportunistic infection for AIDS. Other conditions which pose an increased risk include certain lymphomas (e.g. Hodgkin’s lymphoma), sarcoidosis, and patients on long-term corticosteroid therapy.

Distribution is worldwide. The prevalence of cryptococcosis has been increasing over the past 20 years for many reasons, including the increase in incidence of AIDS and the expanded use of immunosuppressive drugs.

Cryptococcus gattii causes infections in immunocompetent people (those having a functioning immune system), but C. neoformans v. grubii, and v. neoformans usually only cause clinically evident infections in persons who have some form of defect in their immune systems (immunocompromised persons).

People who have defects in their cell-mediated immunity, for example, people with AIDS, are especially susceptible to disseminated cryptococcosis.

Cryptococcosis can rarely occur in the immunocompetent person without HIV, when it usually goes undiagnosed. Less than 250 cases in all are reported in the medical literature, the majority diagnosed postmortem.

Types

- localized cryptococcosis

  • wound cryptococcosis or cutaneous cryptococcosis
  • pulmonary cryptococcosis
  • menigeal cryptococcosis (cryptococcal meningitis)
  • cryptococcal meningoencephalitis
  •  
    - systemic cryptococcosis

Clinical synopsis

Symptoms include fever, fatigue, chest pain, dry cough, swelling of abdomen, headache, blurred vision and confusion.

Diagnosis

Detection of cryptococcal antigen (capsular material) by culture of CSF, sputum and urine provides definitive diagnosis.

Blood cultures may be positive in heavy infections.

Variants

- cryptococcal inflammatory pseudotumors (17895752)

Prognosis

Cryptococcosis is often fatal, especially if untreated.

Digital cases

- HPC:62 (HPC:62) : Nodal cryptococcosis
- JRC:419 : Pulmonary cryptococcosis.
- JRC:421 : Pulmonary cryptococcosis.

See also

- Mycoses

Links

- Wikipedia

References

- Sing Y, Ramdial PK. Cryptococcal inflammatory pseudotumors. Am J Surg Pathol. 2007 Oct;31(10):1521-7. PMID: 17895752

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