Cryptococcosis

Cryptococcosis

Cryptococcosis is an infection by a fungus called Cryptococcus neoformans which may affect various organs including the brain, lungs, skin, prostate and bones.  The infection can result in undisruptive colonization of the airways of healthy people but individuals at risk such as those with low immune status and transplant patients may suffer from fatal consequences of cryptococcosis. ^[1]

Epidemiology

There is no clear racial predilection. More males are affected than females. Most patients have age greater than 40 years. ^[1]

Causes

The illness is caused by fungi that belong to genus Cryptococcus which can affect both humans and animals. Two of the most common are C. neoformans and C. gattii. Cryptococcus neoformans is usually found in fecal material of birds. Humans and animals usually contract the disease when they inhale dust contaminated with these bird feces. C. neoformans typically infect individuals who have weakened immune system in particular HIV patients. On the other hand, majority of patients infected by C. gattii are immunocompetent. ^[2]

Reports show that aside from HIV patients, mostly affected individuals are those taking high doses of corticosteroid drugs, undergoing cancer chemotherapy and with Hodgkin's disease. ^[3]

Signs and Symptoms

People who have normally functioning immune system may not manifest any symptoms. Majority of cases involve the lungs or brain. With lung involvement, the patient may experience a sharp chest pain that is amplified by breathing movements, cough with or without blood. When the brain is infected, there can be headache, blurring of vision, confusion, seizures and the patient may fall into coma. Other symptoms include fever, malaise, weight loss, nausea and vomiting. Some may develop bone pain and skin lesions. ^{[2] [3]}

Diagnosis

After carefully taking the medical history, the physician often performs a physical examination. Findings may include abnormal breath sounds, altered mental status and stiff neck.  Tests that may be done are chest x-ray, blood culture, sputum culture, cerebrospinal fluid culture, bronchoscopy, CT scan, spinal tap and cryptococcal antigen test. ^[3]

Treatment

Some cases may need no treatment at all. Some may be prescribed with antifungal drugs like amphotericin B, flucytosine and fluconazole. ^[3]

References:

1.      http://emedicine.medscape.com/article/215354-overview

2.      http://www.emedicinehealth.com/cryptococcosis/article_em.htm

3.      http://www.nlm.nih.gov/medlineplus/ency/article/001328.htm

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