Cryptococcosis

Abstract

Cryptococcosis is an invasive mycosis caused by pathogenic encapsulated yeasts in the genus Cryptococcus. Cryptococcus gained prominence as a pathogen capable of widespread disease outbreaks in vulnerable populations. We have gained insight into the pathobiology of Cryptococcus, including the yeast' s capacity to adapt to environmental pressures, exploit new geographic environments, and cause disease in both immunocompromised and apparently immunocompetent hosts. Inexpensive, point-of-care testing makes diagnosis more feasible than ever. The associated worldwide burden and mortality remains unacceptably high. Novel screening strategies and preemptive therapy offer promise at making a sustained and much needed impact on this sugar-coated opportunistic mycosis.

Keywords: Central nervous system (CNS) infection; Cryptococcosis; HIV/AIDS; Immune reconstitution inflammatory syndrome (IRIS); Opportunistic mycoses; Solid organ transplantation (SOT).

Fig. 1

Solitary pulmonary nodule. In an asymptomatic patient with isolated pulmonary cryptococcosis. (Courtesy of J. R. Perfect, MD, Durham, NC.)

Fig. 2

India ink staining. Encapsulated yeast seen on India ink preparation of cerebrospinal fluid in a patient with cryptococcal meningitis. (Courtesy of J. R. Perfect, MD, Durham, NC.)