Common signs and symptoms of cryptococcosis include:
Symptoms of brain infection (cryptococcal meningitis)
In people with weakened immune systems, the infection may spread to the brain. Neurological (brain) symptoms appear gradually.
When most people are diagnosed, they have swelling and inflammation in the brain and spinal cord, leading to symptoms such as:
- Neck stiffness
- Nausea and vomiting
- Blurred vision or vision
- Changes in mental status (confused state or coma)
- Hypersensitivity to light
- Abnormalities in the nerves of the cranium
- Cerebral edema
- Hearing impairment or loss
- Increased cranial pressure
- Personality changes
- Difficulty speaking, reading, or writing
- Seizures or loss of muscular coordination
Symptoms of lung infection
Most people with pulmonary infections have no symptoms, but an X-ray may reveal lung lesions.
Common signs and symptoms may include:
- Nonspecific cough
- Dyspnea (shortness of breath)
- Pleuritic chest pain
- Weight loss
- Hemoptysis (coughing up blood)
- Lymphadenopathy (swollen lymph glands)
- Tachypnea (rapid breathing)
- Rales (audible crackles in the lung)
- On rare occasions, pleural effusion occurs
Other symptoms may include:
- Bone pain or tenderness of the breastbone
- Skin rash, including petechiae (pinpoint red spots), 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. People with weakened immune systems are more likely to develop severe pulmonary diseases and respiratory syndromes.
In healthy people, the infection could be self-limiting. However, in people with HIV/AIDS, the fungus can lay dormant in the body and then, reactivate, spreading to other parts of the body and causing serious infections and symptoms.
Infection with cryptococcal fungi can affect various organ systems, including the skin, prostate, adrenal glands, and skin.
What are the causes of and risk factors for cryptococcosis infection?
Although cryptococcosis can infect anyone, it is classified as an opportunistic infection. People with weakened immune systems are more vulnerable to this disease.
- Cryptococcus neoformans
- Causes most human infections, especially in immunocompromised hosts.
- Cryptococcus gattii
- Supposedly caused by breathing in aerosolized organisms.
- Although the pulmonary route has not been proven to be a means of person-to-person transmission, active cryptococcosis in donors has been linked to cases of endophthalmitis and systemic infection after kidney transplants and corneal grafts, respectively.
- Cryptococcosis cases do not typically occur in clusters.
- People with immunologic defects in T-cell-mediated defense mechanisms appear to be at a higher risk of progressive cryptococcosis.
- AIDS is the predisposing factor in approximately 80 to 90 percent of cryptococcal infections.
- The incidence of cryptococcosis is increased in people with lymphoreticular malignancies (especially Hodgkin's disease)
- Diabetes mellitus
- Taking high doses of corticosteroid medications
- Cancer chemotherapy
Infection occurs primarily through inhalation of cryptococcus spores released from soil and bird droppings. It occurs in humans and animals, but no evidence of animal-to-human or human-to-human transmission through respiratory droplets has been found.
Transmission via organ transplantation has been reported when infected donor organs were used. Infection through skin cuts is uncommon, but it does happen.
What are the treatment options for cryptococcosis?
Antifungal medications either orally or intravenously are the treatment of choice. Surgical consideration could be rarely recommended.
Some infections do not need to be treated. To ensure that the infection has not spread, regular checkups should be done for an entire year. Your doctor will prescribe you antifungal medications if you have lung lesions or the infection spreads. It might be necessary to take these medications for a long time.
What are the possible outcomes of cryptococcosis?
People with meningitis have a three-month mortality rate of about 20 percent. The disease is completely fatal if left untreated. Long-term prognosis, particularly for people with AIDS, is linked to the ability to reduce immunosuppression and HIV viral load.
- To prevent disease recurrence in people with AIDS and organ transplant recipients, ongoing suppressive therapy is required.
- Testing for underlying immunosuppression, including HIV testing, is critical for people without known risk factors.
C neoformans are commonly transmitted through bird droppings, particularly pigeon droppings. People with weakened immune systems should avoid contact with birds or areas contaminated by bird droppings.There are no formal recommendations for C. gattii infection prevention.
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