Cryptococcus (Cryptococcosis)

Cryptococcus is a type of fungus that is found in the soil worldwide, usually in association with bird droppings. The major species of Cryptococcus that causes illness in human is Cryptococcus neoformans. Another less common species that can also cause disease in humans, Cryptococcus gattii, has been isolated from eucalyptus trees in tropical and sub-tropical regions. Since 1999, C. gattii has also been found in regions of the Pacific Northwest, particularly Victoria Island in British Columbia, and Oregon and Washington in the United States.

Cryptococcosis is disease due to a species of the fungus Cryptococcus. C. neoformans typically infects immunocompromised persons. Most people in the United States who develop cryptococcal infections are HIV-positive. However, occasionally persons with no apparent immune system problems develop cryptococcosis. Infections with C. gattii have also occurred in healthy persons without compromised immune systems.

Inhalation of airborne fungi. Cryptococcosis is not known to be spread from person to person.

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.

Incubation times vary for infection due to Cryptococcus species. Symptoms from C. gattii infection are estimated to begin anywhere from 2-11 months after exposure. The incubation time for C. neoformans is not known.

Yes, it is very important to seek immediate medical evaluation.

The diagnosis can be made by microscopic examination and/or culture of tissue or body fluids such as blood, cerebrospinal fluid and sputum. The cryptococcal antigen test is a rapid test that can be performed on blood and/or on cerebrospinal fluid to make the diagnosis.

Treatment of meningoencephalitis and other severe infections is usually initiated with an amphotericin B formulation, with or without flucytosine. Fluconazole is used for maintenance therapy in HIV-infected patients with cryptococcal meningoencephalitis, and may be used for patients with milder forms of infection not involving the central nervous system.

C. neoformans is commonly spread by bird droppings, especially pigeon droppings. People who have weakened immune systems should avoid areas contaminated by bird droppings, and should avoid contact with birds. There are no formal recommendations for the prevention of C. gattii infection.