What is the definition of Cryptococcosis?

Cryptococcosis is infection with the fungi Cryptococcus neoformans and Cryptococcus gattii.

What are the alternative names for Cryptococcosis?

C. neoformans var. neoformans infection; C. neoformans var. gatti infection; C. neoformans var. grubii infection

What are the causes for Cryptococcosis?

C neoformans and C gattii are the fungi that cause this disease. Infection with C neoformans is seen worldwide. Infection with C gattii has mainly been seen in the Pacific Northwest region of the United States, British Columbia in Canada, Southeast Asia, and Australia. Cryptococcus is the most common fungus that causes serious infection.

Both types of fungi are found in soil. If you breathe the fungus in, it infects your lungs. The infection may go away on its own, remain in the lungs only, or spread throughout the body (disseminate). Cryptococcosis is most often seen in people with a weak immune system, such as those who:

• Are infected with HIV/AIDS
• Take high doses of corticosteroid medicines
• Cancer
• Are on chemotherapy medicines for cancer
• Have Hodgkin disease
• Have had an organ transplant

C gattii may affect people with normal immune system.

C neoformans is the most common life-threatening cause of fungal infection in people with HIV/AIDS.

People between 20 to 40 years of age have this infection.

What are the symptoms for Cryptococcosis?

The infection may spread to the brain in people who have a weakened immune system. Neurological (brain) symptoms start slowly. Most people have swelling and irritation of the brain and spinal cord when they are diagnosed. Symptoms of brain infection may include:

• Fever and headache
• Neck stiffness
• Nausea and vomiting
• Blurred vision or double vision
• Confusion

The infection can also affect the lungs and other organs. Lung symptoms may include:

• Difficulty in breathing
• Cough
• Chest pain

Other symptoms may include:

• Bone pain or tenderness of the breastbone
• Fatigue
• Skin rash, including pinpoint red spots (petechiae), ulcers, or other skin lesions
• Sweating -- unusual, excessive at night
• Swollen glands
• Unintentional weight loss

People with a healthy immune system may have no symptoms at all.

What are the current treatments for Cryptococcosis?

Some infections require no treatment. Even so, there should be regular checkups for a full year to make sure the infection has not spread. If there are lung lesions or the disease spreads, your provider will prescribe you antifungal medicines. These medicines may need to be taken for a long time.

Medicines include:

• Amphotericin B (can have severe side effects)
• Flucytosine
• Fluconazole

What is the outlook (prognosis) for Cryptococcosis?

Central nervous system involvement often causes death or leads to permanent damage.

When should I contact a medical professional for Cryptococcosis?

Call your provider if you develop symptoms of cryptococcosis, especially if you have a weakened immune system.

REFERENCES

Kauffman CA. Cryptococcosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 336.

Perfect JR. Cryptococcosis (Cryptococcus neoformans and Cryptococcus gattii). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 264.

Robles WS, Ameen M. Cryptococcosis. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson IH, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 49.