Health Encyclopedia

Cryptococcosis

Definition

Cryptococcosis is a rare fungal infection caused by inhaling the fungus Cryptococcus neoformans.

Causes, incidence, and risk factors

Cryptococcus neoformans, the fungus that causes this disease, is ordinarily found in soil. Once inhaled, infection with cryptococcosis may heal on its own, remain localized in the lungs, or spread throughout the body (disseminate).

Most cases occur in people whose resistance to infection is lowered (such as by HIV infection, high doses of corticosteroid medications, cancer chemotherapy, or Hodgkin's disease).

In people with normal immune systems, the pulmonary (lung) form may have no symptoms. However, in people with impaired immune systems, the cryptococcus organism may spread to the brain.

The onset of neurological symptoms is gradual. The majority of people with this condition have meningoencephalitis (swelling and irritation of the brain and spinal cord) at the time of diagnosis.

Cryptococcus is one of the most common life-threatening fungal infections in AIDS patients.

Symptoms

Abdominal fullness prematurely after meals
Abdominal pain
Abdomen, swollen
Bleeding into the skin
Blurred vision or double vision (diplopia)
Bone pain or tenderness of the breastbone (sternum)
Bruises (ecchymoses)
Chest pain
Confusion
Cough -- dry
Fatigue
Fever
Headache
Loss of appetite
Nausea
Nerve pain or pain along the path of a specific nerve or nerve root
Numbness and tingling
Skin rash -- pinpoint red spots (petechiae)
Sweating -- unusual, excessive at night
Swollen glands
Unintentional weight loss
Weakness

Note: In individuals with normal immune systems there may be no symptoms

Signs and tests

Treatment

Some infections require no treatment. However, medical observation should continue for a year to detect any progression of the disease. If pulmonary lesions are present or the disease spreads, antifungal medications are prescribed, and treatment with these agents may be prolonged.

Medications include:

Amphotericin B
Flucytosine
Fluconazole

Expectations (prognosis)

Central nervous system involvement often causes death or leads to permanent damage.

Complications

Relapse of infection
Meningitis
Permanent brain or nerve damage
Side effects of medications (such as Amphotericin B) can be severe

Calling your health care provider

Call your health care provider if symptoms develop that are suggestive of cryptococcosis, particularly if you have an impaired immune system.

Prevention

Minimize doses of corticosteroid medications. Safer sex practices reduce the risk of acquiring HIV and the subsequent opportunistic infections associated with a weakened immune system.

Review Date:10/9/2006
Reviewed By:D. Scott Smith, M.D., MSc, DTM&H, Chief of Infectious Disease & Geographic Medicine, Kaiser Redwood City, CA & Adjunct Assistant Professor, Stanford University. Review provided by VeriMed Healthcare Network.

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