Cryptococcosis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Cryptococcosis can be fatal if unrecognized and untreated, regardless of immune status.
Microbiology, cryptococcal polysaccharide antigen (CrAg), or histopathology are required to make the diagnosis for cryptococcosis.
Treatment depends on the immunologic state and disease severity. For asymptomatic and mild to moderate disease with no central nervous system (CNS) involvement, oral fluconazole is the first-line treatment. For severe disease and CNS involvement, induction therapy with amphotericin-B plus flucytosine followed by consolidation therapy with fluconazole is recommended.
The lungs are generally the primary locus of infection, with extrapulmonary dissemination throughout the body with prominent symptomatic involvement of the brain and meninges and, less commonly, the skin, bones, prostate, and other organs.
Meningoencephalitis is life-threatening, particularly in immunosuppressed patients.

Bilateral cannonball lesions secondary to Cryptococcus neoformans

From the collection of the radiology department, The Prince Charles Hospital, Chermside, Brisbane, Australia; used with permission

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Bilateral cannonball lesions secondary to Cryptococcus neoformans
Pulmonary nodules in right lower lobe and left lower lobe secondary to Cryptococcus neoformans
Bibasal pneumonic consolidation secondary to Cryptococcus neoformans
Bilateral patchy opacification in mid-to-lower zones secondary to Cryptococcus neoformans

Citations

Key Articles

Chayakulkeeree M, Perfect JR. Cryptococcosis. Infect Dis Clin North Am. 2006 Sep;20(3):507-44.[Abstract]
Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: cryptococcosis. July 2021 [internet publication].[Full Text]
World Health Organization. Guidelines for diagnosing, preventing and managing cryptococcal disease among adults, adolescents and children living with HIV. June 2022 [internet publication].[Full Text]
Perfect JR, Dismukes WE, Dromer F, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Diseases Society of America. Clin Infect Dis. 2010 Feb 1;50(3):291-322.[Abstract][Full Text]
Boulware DR, Meya DB, Muzoora C, et al. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis. N Engl J Med. 2014 Jun 26;370(26):2487-98.[Abstract][Full Text]
Rolfes MA, Hullsiek KH, Rhein J, et al. The effect of therapeutic lumbar punctures on acute mortality from cryptococcal meningitis. Clin Infect Dis. 2014 Dec 1;59(11):1607-14.[Abstract][Full Text]
Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. April 2022 [internet publication].[Full Text]

Referenced Articles

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