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Cryptococcosis is a fungal infection caused by the yeasts of the Cryptococcus neoformans species. It is most common in immunocompromised people (HIV-infected people are particularly at risk), who can lead to poor prognosis of the meninges and brain. Less commonly, it affects the skin or the gastrointestinal tract.
Cryptococcosis – the definition of the disease
Cryptococcosis is a type of ringworm (European yeast infection) caused by a fungus belonging to the fungus class Cryptococcus neoformans. It is an acute or subacute respiratory disease. This microorganism is present all over the world and mainly attacks the central nervous system, skin, lungs and subcutaneous tissue. Its reproduction occurs through budding, and its greatest amount can be found in the excrements of hens and pigeons. Sometimes this fungus was also found in fruit, in cow’s milk (from a sick cow), and even in dust.
Cryptococcosis – causes
Cryptococcosis is a disease caused by a fungus Cryptococcus neoformans. It is common in the environment, especially in cities where we can find a large number of pigeons. For infection to occur, you must introduce dust particles contaminated with pigeon droppings into the body by breathing or, less frequently, through the damaged skin.
Fungi-induced cryptococcosis can take the form of mycosis:
- skin – related to the subcutaneous tissue,
- organ – then it attacks the lungs and the central nervous system,
- superficial.
Influence of immunity on the appearance of symptoms of cryptococcosis infection
It is rare to become seriously ill if you are in good health with normal immunity. Then, if it ever becomes infected, it is usually asymptomatic or mild enough that symptoms resolve on their own. When you are immunocompromised, cryptococcosis can have serious consequences for a variety of reasons. If, for example, you are a person suffering from leukemia, lymphoma, hypogammaglobulinemia, you suffer from diabetes, lupus erythematosus, you consume alcohol excessively and you are addicted to it; when you have had an organ transplant, you are undergoing immunosuppressive treatment, your immunity is significantly lowered and you may experience severe symptoms of cryptococcosis. You will be at particular risk of such a course if you are HIV-infected.
Cryptococcosis – symptoms
What are the consequences of the infection Cryptococcus neoformans?
When the fungus Cryptococcus neoformans finds itself in your body, it inhabits the lungs first. If you are an immunocompromised person, this disease may take different stages.
Acute course of cryptococcosis: the fungus fills the alveoli, which are like bubbles that make up the lung and which must be open to be able to breathe properly. It also clogs the capillaries that wrap around the alveoli in the lungs and are needed to bring the oxygen taken in the lungs to the blood and distribute it to all cells in the body. As it impairs lung function, it can lead to the so-called acute respiratory distress and thus become seriously ill. Moreover, such a condition contributes to the spread of the infection. The fungus can get through the bloodstream to your meninges and brain, causing them to become inflamed and even form brain abscesses. Cryptococcosis affects the skin, gastrointestinal tract and lymph nodes less often.
What changes occur with long-term infection?
The fungus can sit in the lungs and keep growing. Then, changes are formed that in the radiographic image may resemble those in tuberculosis. This condition requires diagnostics. When the meninges and the brain are affected, this may only be a headache at first. But what’s important! The brain is hidden in the bone shell, which is the skull. If we have a full glass of water and we want to add some more water to it, the water will run out, not fitting the glass. In the case of the brain, if something grows in it, it cannot go outside because of the bony skull and, as in the case of a glass, it cannot spill out. Therefore, when the fungus grows in the brain tissue (when the so-called fungal nodules form), the so-called intracranial pressure, which is the pressure inside the skull. This can have serious consequences, see below.
Severe course of cryptocurosis in immunocompromised people
Cryptococcosis is a serious disease when you have impaired immunity. Then the most common form is the aforementioned meningitis and encephalitis. Symptoms may be poorly expressed at first:
- slightly increased temperature,
- malaise, you don’t want anything, it’s hard to focus on anything,
- headaches,
- nausea,
- possibly associated pulmonary symptoms similar to tuberculosis, such as cough.
More severe symptoms can later be expected:
- vomiting,
- walking problems
- meningeal symptoms that the doctor can find out on the examination,
- pressure symptoms, i.e. those that are formed as a result of fungus growth inside the skull. Such a fungus oppresses various structures and can cause, for example, nystagmus, paralysis of the cranial nerves, amblyopia.
Cryptococcosis and AIDS
If you are an HIV-infected person, then CNS cryptococcosis is recognized as the so-called indicator disease. That is, a disease that, if it occurs in the state of HIV infection, allows the diagnosis of full-blown AIDS.
Diagnosis and treatment of cryptococcosis
The diagnosis of cryptococcosis and its treatment is carried out in a hospital setting. To recognize cryptococcosis, download material to microbiological testing. It is a test that allows you to see a microorganism suspected of causing a disease under a microscope. Such material may be sputum, urine, blood, cerebrospinal fluid. These are the steps needed to make a proper diagnosis.
Treatment of cryptococcosis should take place in a hospital setting, where there is a possibility of intravenous antibiotics. In the case of meningitis, it is a long-term treatment intravenously (approximately 6 weeks). Later, therapy is continued by taking medications orally. The mainstay of treatment is the administration of two preparations to patients: amphotericin B and 5-fluorocytosine. The combination of these two drugs brings greater effects of treatment and at the same time reduces the risk of relapse. In addition, it allows you to lower the dose of amophotercin B, which is much more toxic than 5-fluorocytosine.
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