Cryptococcosis
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| Cryptococcosis Classification and external resources | |
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| Histopathological image of pulmonary cryptococcosis in an immunocompromised host. Alcian blue-PAS stain. | |
| ICD-10 | B45. |
| ICD-9 | 117.5 |
| DiseasesDB | 3213 |
| eMedicine | med/482 |
| MeSH | D003453 |
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US National Guidelines Clearinghouse on Cryptococcosis NICE Guidance on Cryptococcosis
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Cryptococcosis is an infection acquired by inhalation of soil contaminated with the encapsulated yeast (fungus) Cryptococcus neoformans.
Etiology and Incidence
Cryptococcosis is a defining opportunistic infection for AIDS, although patients with Hodgkin's or other lymphomas or sarcoidosis or those receiving long-term corticosteroid therapy are also at increased risk.
Distribution is worldwide. The prevalence of cryptococcosis has been increasing over the past 20 years for many reasons, including the increase in indicence of AIDS and the expanded use of immunosuppressive drugs.
In humans, C. neoformans causes three types of infections:
- Wound or cutaneous cryptococcosis
- Pulmonary cryptococcosis, and
- Cryptococcal meningitis.
Cryptococcal meningitis (infection of the brain) is believed to result from dissemination of the fungus from either an observed or unappreciated pulmonary infection. Cryptococcus gattii causes infections in immunocompetent people (those having a functioning immune system), but C. neoformans v. grubii, and v. neoformans usually only cause clinically evident infections in persons who have some form of defect in their immune systems (immunocompromised persons). People who have defects in their cell-mediated immunity, for example, people with AIDS, are especially susceptible to disseminated cryptococcosis. Cryptococcosis is often fatal, especially if untreated.
Diagnosis
Symptoms include chest pain, dry cough, swelling of abdomen, headache, blurred vision and confusion. Although symptoms may not be able to be detected.
Detection of cryptococcal antigen (capsular material) by culture of CSF, sputum and urine provides definitive diagnosis. Blood cultures may be positive in heavy infections.
Treatment
The standard regimen of treatment in non-AIDS patients intravenous Amphotericin B combined with oral flucytosine.
AIDS patients often have a reduced response to Amphotericin B and flucytosine, therefore after initial treatment as above, oral fluconazole can be used.
External links
- The Merck Manual
- Health AtoZ
- synd/1793 at Who Named It
- See pathology video with commentary of brain tissue infested by cryptoccocus neoformans
Mycoses (B35-B49, 110-118) | |
|---|---|
| Tinea: Dermatophytosis | Tinea barbae - Tinea capitis - Tinea corporis (Ringworm) - Tinea cruris - Tinea manuum - Tinea pedis (Athlete's foot) - Tinea unguium/Onychomycosis |
| Tinea: Other superficial mycoses | Tinea versicolor - Tinea nigra - White piedra |
| Dimorphic fungi | Coccidioidomycosis - Histoplasmosis - Blastomycosis - Paracoccidioidomycosis - Sporotrichosis |
| Other | Candidiasis (Oral candidiasis) - Chromoblastomycosis - Aspergillosis - Cryptococcosis - Phycomycosis/Mucormycosis - Mycetoma (Eumycetoma, Maduromycosis, Actinomycetoma) - Lobo's disease - Pneumocystis pneumonia |
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
