Cryptococcosis

Cryptococcosis is an infection caused by the fungus Cryptococcus neoformans or Cryptococcus gattii.

• People may have no symptoms or may have headache and confusion, a cough and an achy chest, or a rash, depending on where the infection is.

• The diagnosis is based on culture and examination of tissue and fluid samples.

• Antifungal medications are given by mouth or, if the infection is severe, intravenously.

(See also Overview of Fungal Infections.)

Cryptococcus neoformans occurs primarily in soil that is contaminated with bird droppings, particularly those of pigeons. Cryptococcus gattii usually is present in certain species of trees. These fungi are found all over the world. Unlike Cryptococcus neoformans, Cryptococcus gattii is not associated with birds.

Outbreaks of Cryptococcus gattii have occurred in the Canadian province of British Columbia, the U.S. Pacific Northwest, Papua New Guinea, northern Australia, and in the Mediterranean region of Europe.

Cryptococcus infection was relatively rare until the AIDS epidemic began. Cryptococcosis is a defining opportunistic infection for people with AIDS.

The fungus tends to infect people who have a weakened immune system, including those with the following:

• AIDS

• Hodgkin lymphoma or another lymphoma

• Sarcoidosis

• Use of medications that suppress the immune system, such as those used to prevent rejection of an organ transplant and, when taken for a long time, corticosteroids

However, cryptococcosis caused by Cryptococcus gattii can also develop in people with a normal immune system. It is also more likely to occur in people who have other lung disorders, are 50 years old or older, or smoke tobacco.

Infection usually occurs when people inhale the spores of the fungus. Thus, cryptococcosis typically affects the lungs. It most commonly spreads to the brain and tissues covering the brain and spinal cord (meninges), resulting in meningitis.

Cryptococcosis may also spread to the skin and other tissues, such as the bones, joints, liver, spleen, kidneys, and prostate.

Symptoms of Cryptococcosis

Cryptococcosis usually causes mild and vague symptoms. Other symptoms vary depending on where the infection is:

• Lung infection: No symptoms in some people, a cough or an aching chest in others, and, if the infection is severe, difficulty breathing

• Meningitis: Headache, blurred vision, depression, agitation, and confusion

• Skin infection: A rash, consisting of bumps (sometimes filled with pus) or open sores

Cryptococcosis That Spreads to the Skin

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Cryptococcosis may spread to the skin and cause a rash of bumps (sometimes filled with pus) or open sores.

Image courtesy of www.doctorfungus.org © 2005.

Lung infection is rarely dangerous. Meningitis is life threatening.