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Cryptococcosis

Category: Illness or disabilities

Type

Involuntary

Introduction and description

 

Cryptococcosis, also known as cryptococcal disease, is a potentially fatal fungal disease. It is caused by one of two species;

  • Cryptococcus neoformans and
  • Cryptococcus gattii.

These were all previously thought to be subspecies of C. neoformans but have now been identified as distinct species.  Cryptococcosis  is found worldwide in soil. 

Cryptococcosis is believed to be acquired by inhalation of the infectious propagule from the environment. Although the exact nature of the infectious propagule is unknown, the leading hypothesis is the basidiospore created through sexual or asexual reproduction.

The prevalence of cryptococcosis has been increasing over the past 20 years for a number of reasons, including the increase in incidence of AIDS but more particularly the increasing use of immunosuppressive drugs.  Thus anyone who has a compromised immune system is at risk, whether this is caused by nutritional deficiency, a virus like HIV or immunosuppressant drugs.

Cryptococcosis is a “defining opportunistic infection for AIDS”, and is the second-most-common AIDS-defining illness in Africa.  Other conditions that cause a compromised immune system and thus can result in the disease include certain lymphomas (e.g., Hodgkin's lymphoma), sarcoidosis, and liver cirrhosis.

Patients on long-term or short term immunosuppressants are at great risk.

Cryptococcosis is often fatal, even if treated.

It is estimated that the three-month case-fatality rate is 9% in high-income regions, 55% in low/middle-income regions, and 70% in sub-Saharan Africa.

As of 2009 there were globally approximately 958,000 annual cases and 625,000 deaths within three months after infection.

 

Symptoms

Symptoms include fever, fatigue, dry cough, headache, blurred vision, and confusion. Symptom onset is often subacute, progressively worsened over several weeks.

In humans, C. neoformans causes three types of infections:

  • Wound or cutaneous cryptococcosis
  • Pulmonary cryptococcosis
  • Cryptococcal meningitis.

The two most common presentations are meningitis (an infection in and around the brain) and pulmonary (lung) infection.

 

Cryptococcal meningitis (infection of the meninges, the tissue covering the brain) is believed to result from dissemination of the fungus from either an observed or unappreciated pulmonary infection. Often there is also silent dissemination throughout the brain when meningitis is present.

Cryptococcus gattii can cause infections in immunocompetent people (fully functioning immune system), but C. neoformans v. grubii, and v. neoformans usually only cause clinically evident infections in persons with some form of defect in their immune systems (immunocompromised persons) whatever the cause of this - pharmaceuticals or viruses. People with defects in their cell-mediated immunity, for example, people with AIDS, are especially susceptible to disseminated cryptococcosis.

Cryptococcosis is often fatal, even if treated.

Diagnosis

Detection of cryptococcal antigen (capsular material) by culture of CSF, sputum and urine provides definitive diagnosis.

Wikipedia
Blood cultures may be positive in heavy infections. India ink of the CSF is a traditional microscopic method of diagnosis, although the sensitivity is poor in early infection, and may miss 15-20% of patients with culture-positive cryptococcal meningitis. Unusual morphological forms are rarely seen. Cryptococcal antigen from cerebrospinal fluid is the best test for diagnosis of cryptococcal meningitis in terms of sensitivity. Apart from conventional methods of detection like direct microscopy and culture, rapid diagnostic methods to detect cryptococcal antigen by latex agglutination test, lateral flow immunochromatographic assay (LFA), or enzyme immunoassay (EIA). A new cryptococcal antigen LFA was FDA approved in July 2011.   Polymerase chain reaction (PCR) has been used on tissue specimens.

Treatment

Stop using the immunosuppressants.

Your only allies in healing are plants.

 

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