C. neoformans Infection

Cryptococcus neoformans (abbreviated C. neoformans) is a fungus that lives in the environment throughout the world. People can become infected with C. neoformans after breathing in the microscopic fungus, although most people who are exposed to the fungus never get sick from it.

Infection with the fungus Cryptococcus (either C. neoformans or C. gattii) is called cryptococcosis. Cryptococcosis usually affects the lungs or the central nervous system (the brain and spinal cord), but it can also affect other parts of the body. Brain infections due to the fungus Cryptococcus are called cryptococcal meningitis.

C. neoformans infections are rare in people who are otherwise healthy. Most cases of C. neoformans infection occur in people who have weakened immune systems, particularly those who have advanced HIV/AIDS.

Source

C. neoformans lives in the environment throughout the world. The fungus is typically found in soil, on decaying wood, in tree hollows, or in bird droppings.

C. neoformans infections are not contagious. Humans and animals can get the infection after inhaling the microscopic fungus from the environment. Some research suggests that people may be exposed to C. neoformans in the environment when they are children. Most people who breathe in C. neoformans never get sick from it. However, in people who have weakened immune systems, C. neoformans can stay hidden in the body and cause infection later when the immune system becomes too weak to fight it off.

Riskfactors

C. neoformans infections are rare among people who are otherwise healthy. Most cases of C. neoformans infection occur in people who have weakened immune systems, such as people who:

• Have advanced HIV/AIDS,
• Have had an organ transplant, or
• Are taking corticosteroids, medications to treat rheumatoid arthritis, or other medications that weaken the immune system.

Signs and symptoms

C. neoformans usually infects the lungs or the central nervous system (the brain and spinal cord), but it can also affect other parts of the body. The symptoms of the infection depend on the parts of the body that are affected. In the lungs A C. neoformans infection in the lungs can cause a pneumonia-like illness. The symptoms are often similar to those of many other illnesses, and can include:

• Cough
• Shortness of breath
• Chest pain
• Fever
• In the brain (cryptococcal meningitis)

Cryptococcal meningitis is an infection caused by the fungus Cryptococcus after it spreads from the lungs to the brain. The symptoms of cryptococcal meningitis include:

• Headache
• Fever
• Neck pain
• Nausea and vomiting
• Sensitivity to light
• Confusion or changes in behavior

Diagnosis

Healthcare providers rely on your medical history, symptoms, physical examinations, and laboratory tests to diagnose a C. neoformans infection.

Your healthcare provider will take a sample of tissue or body fluid (such as blood, cerebrospinal fluid, or sputum) and send the sample to a laboratory to be examined under a microscope, tested with an antigen test, or cultured. Your healthcare provider may also perform tests such as a chest x-ray or CT scan of your lungs, brain, or other parts of the body.

Treatment

People who have C. neoformans infection need to take prescription antifungal medication for at least 6 months, often longer. The type of treatment usually depends on the severity of the infection and the parts of the body that are affected.

For people who have asymptomatic infections (e.g., diagnosed via targeted screening) or mild-to-moderate pulmonary infections, the treatment is usually fluconazole. For people who have severe lung infections or infections in the central nervous system (brain and spinal cord), the recommended initial treatment is amphotericin B in combination with flucytosine. After that, patients usually need to take fluconazole for an extended time to clear the infection. The type, dose, and duration of antifungal treatment may differ for certain groups of people, such as pregnant women, children, and people in resource-limited settings. Some people may also need surgery to remove fungal growths (cryptococcomas).

Epidemiology

C. neoformans infections are rare among people who have healthy immune systems; however, C. neoformans is a major cause of illness in people living with HIV/AIDS, with an estimated 220,000 cases of cryptococcal meningitis occurring worldwide each year.

Prevention

It’s difficult to avoid breathing in C. neoformans because it’s thought to be common in the environment. Most people who breathe in C. neoformans never get sick from it. However, in people who have weakened immune systems, C. neoformans can stay hidden in the body and cause infection later when the immune system becomes too weak to fight it off. This leaves a window of time when the silent infection can be detected and treated early, before symptoms develop .

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