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Chronic, subacute to acute pulmonary, systemic or meningitic disease, initiated by the inhalation of the fungus. Primary pulmonary infections have no diagnostic symptoms and are usually subclinical. On dissemination, the fungus usually shows a predilection for the central nervous system, however skin, bones and other visceral organs may also become involved.
Aetiological Agent:Cryptococcus neoformans.
Round 4 – 10 microns
Surrounded by Mucopolysaccharide capsule.
Thick in vivo
Negative staining with India Ink and Nigrosin
60% of the infected prove positive by India Ink preparation on examination of CSF
KoH preparations in Sputum and other tissues,
PAS and Mucicaramine staining helps confirmation.Morphology
Simple urease test helps in confirming the isolate.
A – 80% clinical cases
B – tropical, subtropical – S. California, Hawaii, Brazil, Australia, SE Asia
C – rare
D – Europe – Denmark, Germany, Italy, France, Switzerland
Enters deep into lungs, Men acquires more infections, and women less infected.
Self limiting in most cases,
Pulmonary infections can occur.
Present as discrete nodules - Cryptococcoma.Pathogenesis
Abnormalities of T lymphocyte function aggravates, the clinical manifestations.
In AIDS 3- 20% develop Cryptococcosis.
Present with Chronic meningitis , Meningo encephalitis
Manifest with – head ache low grade fever,
Visual abnormalities ,Coma – fatal
Treatment reduces the morbidity and cure in non immune suppressed expected.Pathogenesis
Direct microscopy - Gram staining
Cultures on Sabouraud dextrose agar,
Serological tests for detection of Capsular antigen
CSF findings mimic like Tuberculosis
IN CSF - latex test for detection of Antigen
Created by Dr.T.V.Rao MD for Medical and Paramedical students in Developing World