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Cryptococcosis
| Cryptococcosis | |
|---|---|
| Other names | Busse-Buschke disease, cryptococcic meningitis, cryptococcosis lung, cryptococcosis skin, European Blastomycosis, torular meningitis, torulosis[1] |
 | |
| Micrograph of cryptococcosis showing the characteristically thick capsule of cryptococcus. Field stain. | |
| Pronunciation | |
| Specialty | Infectious disease[4] |
| Symptoms |
|
| Causes | Cryptococcus neoformans,[7] Cryptococcus gattii[8] |
| Risk factors | HIV/AIDS,[9] Aviculture |
| Diagnostic method | Biopsy, culture[9] |
| Treatment | Antifungal medication |
| Medication | |
Cryptococcosis is a potentially fatal fungal infection of mainly the lungs, presenting as a pneumonia, and in the brain, where it appears as a meningitis.[4][9][12] Coughing, difficulty breathing, chest pain and fever are seen when the lungs are infected.[5] When the brain is infected, symptoms include headache, fever, neck pain, nausea and vomiting, light sensitivity and confusion or changes in behavior.[5] It can also affect other parts of the body including skin, where it may appear as several fluid-filled nodules with dead tissue.[6]
It is caused by the fungi Cryptococcus neoformans or less commonly Cryptococcus gattii, and is acquired by breathing in the spores from the air.[4] These fungi are found globally in soil, decaying wood, pigeon droppings, and in the hollows of some species of trees.[9][13] Whereas C. neoformans generally infects people with HIV/AIDS and those on immunosuppressant drugs and does not usually affect fit and healthy people, C. gattii (found in some parts of Canada and the US) does.[9][13] Once breathed in, the dried yeast cells colonize the lungs, where they are either cleared by immune cells, lie dormant, or cause infection and spread.[14]
Diagnosis is by isolating Cryptococcus from a sample of affected tissue or direct observation of the fungus by using staining of body fluids.[9] It can be cultured from a cerebrospinal fluid, sputum, and skin biopsy.[9] Characteristic neuroimaging findings include dilated Virchow-Robin spaces, the ‘dirty CSF sign’,[15] hydrocephalus, cryptococcomas and hazy brain base sign. Many of these findings are non-specific, but the presence of basal meningeal enhancement is significant as it is associated with the future development of cerebral infarct. Treatment is with fluconazole or amphotericin B.[9][10]
Data from 2009 estimated that of the almost one million cases of cryptococcal meningitis that occurred worldwide annually, 700,000 occurred in sub-Saharan Africa and 600,000 per year died.[16] Cryptococcosis was rare before the 1970s which saw an increase in at-risk groups such as people with organ transplant or on immunosuppressant medications.[9] The number of cases escalated in the mid-1980s with over 80% occurring in people with HIV/AIDS.[9] Pigeon breeders (or otherwise people who spend significant time with pigeons) are known to have a high incidence of cryptococcal infections including primary cutaneous cryptococcus due to the fungi's association with pigeon droppings.[17][better source needed]
- ^ "Cryptococcosis". NORD (National Organization for Rare Disorders). Retrieved 5 June 2021.
- ^ "Cryptococcosis". Lexico UK English Dictionary. Oxford University Press. Archived from the original on 2021-05-07.
- ^ "Cryptococcosis". Merriam-Webster.com Dictionary. Merriam-Webster. Retrieved 2016-01-21.
- ^ a b c "ICD-11 — ICD-11 for Mortality and Morbidity Statistics". icd.who.int. Retrieved 5 June 2021.
- ^ a b c d "Symptoms of C. neoformans Infection". Fungal Diseases. Centers for Disease Control and Prevention. 14 January 2021. Retrieved 6 June 2021.
- ^ a b Johnstone RB (2017). "25. Mycoses and Algal infections". Weedon's Skin Pathology Essentials (2nd ed.). Elsevier. p. 446. ISBN 978-0-7020-6830-0.
- ^ "C. neoformans Infection". Fungal Diseases. Centers for Disease Control and Prevention. 29 December 2020. Retrieved 5 June 2021.
- ^ "Where C. gattii Infection Comes From". Fungal Disease. Centers for Disease Control and Prevention. 29 January 2021. Retrieved 5 June 2021.
- ^ a b c d e f g h i j k Maziarz EK, Perfect JR (March 2016). "Cryptococcosis". Infectious Disease Clinics of North America. 30 (1): 179–206. doi:10.1016/j.idc.2015.10.006. PMC 5808417. PMID 26897067.
- ^ a b "Treatment for C. neoformans Infection". Fungal Diseases. Centers for Disease Control and Prevention. 14 January 2021. Retrieved 6 June 2021.
- ^ Cite error: The named reference
Perfect 2010was invoked but never defined (see the help page). - ^ Rocha MF, Bain HD, Stone N, Meya D, Darie L, Toma AK, et al. (January 2025). "Reframing the clinical phenotype and management of cryptococcal meningitis". Practical Neurology. 25 (1): 25–39. doi:10.1136/pn-2024-004133. PMID 38997136.
This article incorporates text from this source, which is available under the CC BY 4.0 license.
- ^ a b "Where C. neoformans Infection Comes From". Fungal Diseases. Centers for Disease Control and Prevention. 2 February 2021. Retrieved 5 June 2021.
- ^ Sabiiti W, May RC (November 2012). "Mechanisms of infection by the human fungal pathogen Cryptococcus neoformans". Future Microbiology. 7 (11): 1297–1313. doi:10.2217/fmb.12.102. PMID 23075448.
- ^ Coughlan CH, Hoskote C, Mehta AR (December 2023). "'Dirty CSF': an MRI feature of CNS fungal infection". BMJ Case Reports. 16 (12): e257720. doi:10.1136/bcr-2023-257720. PMC 10711893. PMID 38061848.
- ^ Vallabhaneni S, Mody RK, Walker T, Chiller T (2016). "1. The global burden of fungal disease". In Sobel J, Ostrosky-Zeichner L (eds.). Fungal Infections, An Issue of Infectious Disease Clinics of North America. Philadelphia: Elsevier. pp. 3–4. ISBN 978-0-323-41649-8.
- ^ Walter JE, Atchison RW (July 1966). "Epidemiological and immunological studies of Cryptococcus neoformans". Journal of Bacteriology. 92 (1): 82–87. doi:10.1128/jb.92.1.82-87.1966. PMC 276199. PMID 5328755.
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