Cryptococcus

Question 1

What class of fungus is cryptococcus?

Answer 1

Basidiomycete

Question 2

What are the primary diseases caused by C. Neoformans?

Answer 2

• Meningoencephalitis in AIDs
• Pneumonia
• Disease may be see in immunocompromised or immunocompetent

Question 3

Who is at risk for C. gattii infection?

Answer 3

Immunocompetent individuals

Question 4

What geographic region is associated with C. Gattii?

Answer 4

The pacific northwest

Question 5

What is the environmental exposure associated with C. Neoformans?

Answer 5

Pigeon droppings

Question 6

C. neoformans has been categorized into 4 serotypes. Which serotype is a minor cause of meningitis in immunocompromised individuals?

Answer 6

Serotype D

Question 7

C. neoformans has been categorized into 4 serotypes. Which serotype is a major cause of meningitis in immunocompromised individuals?

Answer 7

Serotype A

Question 8

Serotypes B and C create which class?

Answer 8

C. Gattii

Question 9

What diseases and in which population does C. Gattii cause disease?

Answer 9

Pneumonia/meningitis in immunocompetent individuals and animals.

Question 10

How does C. neoformans and c. gattii become airborne?

Answer 10

Through the production of basidiophores.

Question 11

In which form does C. neoformans grow in patient samples or lab cultures?

Answer 11

As a yeast

Question 12

What are the virulence factors of cryptococcus?

Answer 12

1. Ability to grow at 37 C
2. Anti-phagocytic, polysaccharide capsule
3. Survives within macrophages

Question 13

What are the unique environmental exposures for C. Gattii?

Answer 13

Dust from eucalyptus and other tree material

Question 14

What are the invasive diseases caused by cryptococcus?

Answer 14

1. Pulmonary cryptococcosis
2. CNS cryptococcosis
3. other disseminated disease.

Question 15

Which form of cryptococcus is more virulent?

Answer 15

C. Gattii

Question 16

What is the primary presenting pathology for C. Gattii in normal persons?

Answer 16

Pneumonia

Question 17

What are cryptococcomas?

Answer 17

necrotizing or fibrosing granulomas caused by C. Gattii in normal persons.

Question 18

What is the clinical presentation of pulmonary cryptococcosis?

Answer 18

Fever, dypsnea, malaise, cough with scant sputum.

Question 19

What can pulmonary cryptococcosis be confused with in terms of clinical presentation?

Answer 19

PCP

Question 20

When do AIDs puts often become diagnosed with cryptococcus?

Answer 20

When they develop signs and symptoms f meningitis. They may have no respiratory symptoms.

Question 21

Symptoms of CNS cryptococcosis

Answer 21

headache, AMS, personality changes, confusion, lethargy, coma, nausea, vomiting, stiff neck is LESS common

Question 22

After the CNS, what are the most commonly involved organs of cryptococcus infection?

Answer 22

Skin, prostate, medullary cavity of the bones

Question 23

What is the best way to diagnose cryptococcus

Answer 23

Get an appropriate sample–> do direct examination of he CSF, examine for cryptococcal antigen, microscopic examination w/ India ink and culture to confirm the diagnosis.

Question 24

Is there a vaccine for cryptococcus?

Answer 24

No

Question 25

when is anti fungal prophylaxis used?

Answer 25

In aids pts for prevention of histoplasmosis and cryptococcosis

Question 26

What is induction therapy for cryptococcosis invasive disease?

Answer 26

IV ampho B + oral 5-flucytosine

Question 27

What is consolidation therapy for cryptococcosis invasive disease?

Answer 27

oral fluconazole 400 mg/day for 8 weeks or until CSF culture is negative

Question 28

What is maintenance therapy for cryptococcosis invasive disease?

Answer 28

Oral fluconazole 200 mg/day for life or until CD4 >200 for 6 months.