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Cryptococcosis - Symptoms & Treatment


Cryptococcosis is a chronic, subacute to acute pulmonary, systemic or meningitic disease, initiated by the inhalation of basidiospores and desiccated yeast cells of Cryptococcus neoformans. It mainly occurs in the tissues covering the brain and spinal cord, resulting in meningitis; in the lungs; and on the skin. Cryptococcosis can result in a variety of clinical signs depending on the organ system involved. Cryptococcosis is a defining opportunistic infection for AIDS, although patients with Hodgkin's or other lymphomas or sarcoidosis or those receiving long-term corticosteroid therapy are also at increased risk. In some forms of Cryptococcosis, symptoms may be limited to the lungs. Cryptococcus grows readily from soil contaminated with avian excreta, particularly those of pigeons, possibly because excreta are rich in xanthine, creatinine, urea, and uric acid, all of which Cryptococcus can assimilate. In most cases, the infection begins in the lungs and may then spread to the brain, urinary tract, skin, and/or bones.

Cryptococcosis may affect any organ in the body, but its most serious form of disease is cryptococcal meningitis. Most people do not get sick with cryptococcosis, but some people are more likely than others to get this disease. Patients infected with C neoformans var gattii are usually immunocompetent, respond slowly to treatment, and are at risk for developing intracerebral mass lesions. People with lung infection may not have any symptoms, although some have cough or an aching chest. Transmission occurs mainly by inhalation. Cutaneous cryptococcosis is a sign of dissemination present in approximately 10% of cases and may precede life-threatening disease by several weeks. Blindness may develop due to cerebral edema or direct involvement of the optic tracts. If limited to the lungs, C neoformans infection may cause pneumonia, poorly defined mass lesions, pulmonary nodules, and, rarely, pleural effusion. In some forms of Cryptococcosis, symptoms may be limited to the lungs. The majority of people with this condition have meningoencephalitis at the time of diagnosis.

Causes of Cryptococcosis

The common causes and risk factor's of Cryptococcosis include the following:

  • A fungus known as Filobasidiella Neoformans or Cryptococcosis Neoformans.
  • Lowered resistance to infection.
  • HIV (AIDS).
  • Contact with an infected individual.
  • Immunocompromise.

Symptoms of Cryptococcosis

Some sign and symptoms related to Cryptococcosis are as follows:
  • Fatigue and fever.
  • Chest pain.
  • Dry cough.
  • Prolonged bleeding.
  • Confusion.
  • Skin rash may be present.
  • Headache.
  • Blurred vision or double vision (diplopia).
  • Shortness of breath.

Treatment of Cryptococcosis

Here is list of the methods for treating Cryptococcosis:

  • The standard regimen of treatment in non-AIDS patients intravenous Amphotericin B combined with oral flucytosine.
  • Ventricular shunting may be necessary if hydrocephalus (cerebral spinal fluid build up in the brain) occurs.
  • Patients with AIDS will also need long-term therapy, usually with oral fluconazole.
  • Positive cultures persist or recur during active antifungal therapy in some patients.
  • Another regimen often used is initial amphotericin B plus Flucytosine for the initial 2 weeks, followed by Fluconazole for 8 weeks.

 

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