Complete Information on Cryptococcosis

By: Juliet Cohen

Cryptococcosis is a rare fungal infection caused by inhaling the fungus Cryptococcus neoformans. Cryptococcus is present around the world, but infection was relatively rare until the AIDS epidemic began. Cryptococcosis is the cause of the most common life-threatening meningitis in AIDS. In the United States, 6-10% of all patients with AIDS get cryptococcosis. Cryptococcal meningitis (infection of the brain) is believed to result from dissemination of the fungus from either an observed or unappreciated pulmonary infection. Cryptococcus gattii causes infections in immunocompetent people (those having a functioning immune system).

People who have defects in their cell-mediated immunity. Most people in the United States who develop cryptococcal infections. Infections with C. gattii have also occurred in healthy persons without compromised immune systems. Cryptococcal infection may cause a pneumonia-like illness, with shortness of breath, coughing and fever. Skin lesions may also occur. Another common form of cryptococcosis is central nervous system infection, such as meningoencephalitis. People with cryptococcal meningoencephalitis are usually immunocompromised. Symptoms may include fever, headache, or change in mental status.

Symptoms from C. gattii infection are estimated to begin anywhere from 2-11 months after exposure. In addition to the brain, the cryptococcal infection can spread to the kidneys, bone marrow, heart, adrenal glands, lymph nodes, urinary tract, blood, and skin. C neoformans infection is usually characterized by little or no necrosis or organ dysfunction until late in the disease. Organ damage may accelerate in persons with heavy infections. Cryptococcal disease is reportedly more common in men than in women. There are many treatment to treat this condition properly. Fluconazole is used for maintenance therapy in HIV-infected patients.

Amphotericin B, with or without 5-flucytosine, is given for several weeks until the patient is stable, after which the patient receives oral fluconazole (Diflucan). Do not use currently available azoles in the initial treatment of disseminated or CNS cryptococcal disease. Many prevention tips is also helpful this condition. Minimize doses of corticosteroid medications. Safer practices reduce the risk of acquiring HIV and the subsequent opportunistic infections associated with a weakened immune system.

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