CRYTOCOCCOSIS

Cryptococcosis and cryptococcal pneumonia refer to infection with cryptococcus neoformans, an encapsulated yeast that can cause meningoencephalitis, usually in immunocompromised patients.

Incidence

- Immunocompromised patients: 2-4 cases per 1,000

- General Population: 0.2-0.9 cases per 100,000

Clinical Signs

- Fever, headache, nausea and vomiting, problems with vision, and confused thinking.

- Pneumonia signals lung disease.

- Skin sores may be possible as well.

- Transmitted via inhalation from bird droppings.

- Evades host via capsular polysaccharide, resistance to macrophage killing, and production of phenol oxidase enzyme

  that consumes epinephrine to protect from protective oxidative reactions.

- Resides mainly in lung.

- Can cause granulomatous chronic inflammatory reactions.

- Gets into the CNS and grows in meninges.

- Mucicarmine stain makes the capsular polysaccharide visible (it stains bright red) - (see Robbins, p. 380)

- PAS stain makes the organism visible as a pale round object.

- Slide 1 shows cryptococcosis of brain.

- Slides 2 and 4 displays cryptococccal pneumonia of lung.