Cryptococcosis is caused by Cryptococcus neoformans. Cryptococcosis may present with central nervous system disturbance which later progress into chronic meningitis. Patient may also present with pneumonia and bone involvement as well as lesion of the skin.
Cryptococcus neoformans may be detected by using the India ink stain of the cerebrospinal fluid. The india ink stain may reveal encapsulated yeast ( cells surrounded by halo ). Cryptococcal polysaccharide antigen in cerebrospinal fluid detection or latex agglutination is consider in diagnosing cryptococcosis.
Cryptoccocus neoformans may enter the lung through inhalation of yeast in the soils or form pigeon dropping. There will be hematogenous spread into the meninges and the brain.Dissemination is possible due to inhibition of phagocytosis by macrophages and neutrophils due to the polysaccharide capsules of the Cryptococus neoformans.
Cryptococcus neoformans most commonly affecting patient with immunocompromised state such as organ transplant recipient or AIDS patient ( mostly present with meningitis).
The treatment of cryptococcosis may include prevention by avoiding any area with pigeon excreta in immunocompromised patient and amphotericin B and flucytosine in disseminated cases of cryptococcosis as well as fluconazole in preventing relapses.
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