Epidemiology

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Etiology

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Pathophysiology

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Clinical features

• Cryptococcal meningoencephalitis or brain abscess
  • Hematogenous spread of fungi to meninges
  • Headache, fever, signs of increased intracranial pressure, confusion, absent meningeal signs
• Pulmonary cryptococcosis
  • Most commonly seen in immunocompromised patients
  • Clinical presentation is variable and nonspecific (e.g., cough, fever, shortness of breath).

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Diagnostics

• Latex agglutination test: positive for cryptococcal polysaccharide capsular antigen
  • High specificity and sensitivity
  • Specimen: Blood or CSF
• CSF analysis
  • India ink stain: clear halo; Round or oval budding yeast
  • Mucicarmine: stains the thick inner polysaccharide capsule bright red
  • Fungal culture (Sabouraud agar) showing:
    • 5–10 μm yeast
    • Thick polysaccharide capsule
    • Narrow, unequal budding
• MRI: “Soap bubble” lesions in cryptococcal encephalitis

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Treatment

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