Cryptococcosis

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Cryptococcosis
Cryptococcus neoformans
Synonyms
Pronounce	N/A
Specialty	N/A
Symptoms	Fever, headache, cough, shortness of breath, confusion
Complications	Meningitis, pneumonia, skin lesions
Onset	Gradual
Duration
Types	N/A
Causes	Cryptococcus neoformans, Cryptococcus gattii
Risks	HIV/AIDS, immunosuppressive therapy, organ transplantation
Diagnosis	India ink stain, cryptococcal antigen test, culture
Differential diagnosis	Tuberculosis, histoplasmosis, coccidioidomycosis
Prevention
Treatment	Antifungal medications such as amphotericin B, flucytosine, fluconazole
Medication
Prognosis
Frequency
Deaths

Cryptococcosis is an acute or chronic, localized or disseminated infection by few species of Cryptococcus (most often Cryptococcus neoformans or Cryptococcus gattii).

Cryptococcosis

Cryptococcosis

Cryptococcosis is believed to be acquired by inhalation of the infectious propagule from the environment. In humans, C. neoformans causes three types of infections: Sites of involvement include the lungs, central nervous system and meninges, skin, and visceral organs.

• Wound or cutaneous cryptococcosis
• Pulmonary cryptococcosis
• Cryptococcal meningitis.

Risk factors

Cryptococcosis is a defining opportunistic infection for AIDS, and is the second-most-common AIDS-defining illness in Africa. Other conditions that pose an increased risk include certain lymphomas (e.g., Hodgkin's lymphoma), sarcoidosis, liver cirrhosis, and patients on long-term corticosteroid therapy. 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. Cryptococcosis can rarely occur in the non-immunosuppressed people, particularly with Cryptococcus gattii.

Additional images

• File:Pulmonary cryptococcosis (1) histiocytic penumonia.jpg
• File:Pulmonary cryptococcosis (3) Alcian blue-PAS.jpg
• File:Cryptococcus smear MGG 2010-01-26.JPG
• File:Cryptococcus smear MGG 2010-01-27.JPG
• File:Cryptococcus smear PAS 2010-01-26.JPG

Prevention

Antifungal prophylaxis such as fluconazole and itraconazole reduces the risk of contracting cryptococcosis in those with low CD4 cell count and high risk of developing such disease in a setting of cryptococcal antigen screening tests are not available.

Treatment

Treatment options in persons without HIV-infection have not been well studied. Intravenous Amphotericin B combined with flucytosine by mouth is recommended for initial treatment (induction therapy). The medication(s) listed below have been approved by the Food and Drug Administration (FDA) as orphan products for treatment of this condition. Amphotericin B Liposomal (Brand name: AmBisome®) can be used in the treatment of disseminated cryptococcosis including meningitis.

NIH genetic and rare disease info

• NIH info on Cryptococcosis

Cryptococcosis is a rare disease.