Cryptococcosis

Cryptococcosis is subacute/chronic deep mycosis by Cryptococcus neoformans; skin/lung/bone/viscera; CNS most common (~80%); high mortality. Rising with AIDS.

Common Symptoms

Pulmonary infection; granuloma; capsular polysaccharide accumulation; dyspnea; severe headache; restlessness; low fever; nausea; cellulitis

Causes and Pathogenesis

Etiology: round/oval 5-12 µm, Gram-positive, thick capsule, no hyphae/spores, budding; grows at room temp/37°C on Sabouraud (milky mucoid colonies). Serotypes A/B/C/D (A most common in China, then B/D; C absent); capsular antigen in CSF/serum/urine; B/C more 5FC-resistant. Pathogenesis: soil/pigeon droppings; inhaled dust; dry yeast 1 µm enters alveoli; capsule forms in vivo; cell-mediated immunity main defense. Lung granuloma rare; hematogenous CNS spread due to: CSF low antibody, no complement activation, dopamine favors growth. Basilar meningitis, subarachnoid exudate (monocytes/lymphocytes/cryptococci); granulomas; perivascular invasion → brainstem vasculitis/infarct; gelatinous pseudocysts in gray matter. Skin: granulomatous or gelatinous lesions.

Treatment

Drug therapy, supportive therapy

Preventive Measures

Isolated pulmonary, normal CSF/urine, no skin/bone disease = observe. Amphotericin B ± flucytosine; oral amphotericin B reported. Treat underlying disease; prophylactic antifungals/immunostimulants for long-term immunosuppression; protective isolation; treat mucocutaneous foci.

Department to Visit

It is recommended to visit the Infectious Diseases department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.