Cryptococcosis

Cryptococcosis

What is Cryptococcosis?
Cryptococcosis is a fungal infection caused by Cryptococcus species, specifically Cryptococcus neoformans and Cryptococcus gattii. These fungi are commonly found in soil or pigeon droppings. The fungi can enter the body through inhalation and may spread through the bloodstream to the brain and spinal cord, causing meningitis.

Causes
- Cryptococcus neoformans/gattii
- Risk Factors:
- Immunocompromised individuals, such as those with HIV/AIDS, those taking immunosuppressants after organ transplants, and those with certain cancers
- Exposure to bird droppings or the environment contaminated with the fungus

Symptoms
depend on the site of entry:
1. Lungs (most common entry point)
- Dry cough or phlegm, low-grade fever
- Difficulty breathing or chest pain
2. Nervous system (meningitis)
- Severe headache, fever
- Nausea, vomiting, lethargy, confusion, or behavioral changes
- Weakness in the limbs or seizures
3. Other infections (rare)
- Skin rash
- Eye inflammation, infections in other organs

Diagnosis
- Laboratory tests
- Blood or cerebrospinal fluid (CSF) fungal test
- Cerebrospinal fluid (CSF) fungal culture
- Blood or cerebrospinal fluid (CSF) cryptococcal antigen (CrAg) test
- Imaging tests
- Chest x-ray or CT scan if pneumonia is suspected
- Further tests
- Blood tests to assess immunity
- HIV test if HIV status is unknown

Treatment
Depending on the severity and site of infection:
1. Severe infections (e.g., meningitis)
- Initial antifungal therapy with amphotericin B and flucytosine
- Continued treatment with fluconazole
2. Mild lung or skin infections
- Standard doses of fluconazole
- Treatment duration may range from several weeks to several months

Precautions
- Immunocompromised patients require longer treatment
- Follow-up and repeat testing is required

Should or should not:
- Immediate testing and treatment should be performed if cryptococcosis is suspected This is especially true for immunocompromised patients, as symptoms can be severe and life-threatening.
*Do not ignore fever, severe headache, or neurological abnormalities in HIV-infected individuals.



Summary
Cryptococcosis is a dangerous fungal infection for those with compromised immune systems. Treat immediately with antifungal medications and closely monitor the progression.