CRYPTOCOCCUS

Question 1

What kind of pathogen is Cryptococcus?

Answer 1

Invasive fungi

Question 2

What are some strains of Cryptococcus?

Answer 2

C. gatti, C. neoformans

Question 3

How is Cryptococcus transmitted?

Answer 3

Inhalation of soil particles containing spores

Question 4

Who is more susceptible to having a severe Cryptococcus infection?

Answer 4

Immunocompromised: those with HIV, CD4<50 (T-cell/immune cell count lower than 50), chronic steroid users, transplant patients, those with lymphoma

-If healthy: usually self-limiting (will resolve on its own)

Question 5

What is the pathogenesis of Cryptococcus?

Answer 5

A capsule around the organism will protect it from the immune system’s defense mechanisms

Question 6

How would a Cryptococcus infection present?

Answer 6

Pneumonia

If disseminated/spread may cause:
-cryptococcal meningitis
-severe disease
-chronic lung infection
-fungemia (fungi in the bloodstream)
-skin nodules/lesions
-Yeast in cerebrospinal fluid may cause increased intracranial pressure

Question 7

How can a Cryptococcus infection be diagnosed?

Answer 7

-Cryptococcal antigen test
-Cerebrospinal fluid culture and stain (India ink-negative stain under microscope, budding encapsulated fungi will be seen)
-Other cultures: Respiratory, Blood, Tissue

Question 8

How can a Cryptococcus infection be treated?

Answer 8

Pulmonary infection: Fluconazole

CNS infection:
Initial treatment (induction phase)- Flucytosine + Liposomal Amphotericin B
Maintenance treatment (consolidation phase)- Fluconazole
**May require recurrent lumbar puncture/spinal tap to relieve increased intracranial pressure