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Cryptococcus Neoformans

This document summarizes information about Cryptococcus neoformans, a pathogenic yeast that can cause meningitis. It is found worldwide in soil contaminated with bird droppings. It primarily infects immunocompromised individuals, entering through the lungs and potentially spreading to the central nervous system. Symptoms include persistent headache, fever, and night sweats. Diagnosis involves lumbar puncture of cerebrospinal fluid or testing for cryptococcal antigen. Treatment involves amphotericin B and flucytosine initially, followed by long-term fluconazole to prevent recurrence in immunocompromised patients.

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Anthony Ross
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105 views13 pages

Cryptococcus Neoformans

This document summarizes information about Cryptococcus neoformans, a pathogenic yeast that can cause meningitis. It is found worldwide in soil contaminated with bird droppings. It primarily infects immunocompromised individuals, entering through the lungs and potentially spreading to the central nervous system. Symptoms include persistent headache, fever, and night sweats. Diagnosis involves lumbar puncture of cerebrospinal fluid or testing for cryptococcal antigen. Treatment involves amphotericin B and flucytosine initially, followed by long-term fluconazole to prevent recurrence in immunocompromised patients.

Uploaded by

Anthony Ross
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Cryptococcus neoformans

Anthony Ross
Medical Microbiology
PBL #4 Resolution
March 7, 2011
Microbiology
Pathogenic yeast

Independent single cell


(Unicellular)

Extracellular

Form smooth and flat


colonies

Propagate by budding
Reservoir and Transmission
Worldwide occurrence –
No endemic areas

Zoonotic reservoir –
found in soil
contaminated with bird
droppings

Transmission –
Respiratory droplets
(inhaled yeast from the
environment)
Risk Factors
Individuals with defective cell-mediated
immunity
◦ Patients with AIDS

◦ Patients undergoing organ transplantation

◦ Patients undergoing corticosteroid treatment

◦ Patients with sarcoidosis


Virulence Factors
Polysaccharide capsule
◦ Inhibits phagocytosis
◦ Aids in laboratory diagnosis
◦ Source of cryptococcal antigen

Melanin Production
◦ Protection against oxidative
stress

Grows well at 37°C (Body


Temperature)
Pathogenesis
Enters body through
respiratory tract

May spread
hematogenously to
other organs – most
common is CNS

Not fully understood


Immune Response
Host defenses are important in preventing
the infection

Bothhumoral and cellular mediated


immunity

Cell-Mediated Immunity = Most


Important
Clinical Presentations
Usually occurs in immunocompromised
patients:
◦ Meningitis

◦ Pulmonary Involvement

◦ Skin Lesions

◦ Cryptococcemia
Cryptococcal Meningitis
Most common complication

Occurs in up to 10% of persons with AIDS

Symptoms
◦ Persistent, dull headache
◦ Malaise
◦ Fever
◦ Night Sweats
◦ May not have meningeal signs
Diagnosis
 Lumbar Puncture for CSF
◦ Presence of White Blood Cells
◦ Elevated Protein
◦ Slightly Depressed Glucose

 India Ink Stain – yeast with


large capsule

 Serology – Cryptococcal
Antigen
◦ Serum
◦ CSF

 Culture on Fungal Media


Treatment
Antifungal Therapy
◦ Initial Therapy
 Amphotercin B and Flucytosine (2 weeks)
◦ Maintenance Therapy
 Fluconazole (8 to 10 weeks)

Treat immunosuppression if possible


Anti-Fungal Drugs
Amphotercin B
◦ Binds to ergosterol
◦ Increases membrane permeability

Flucytosine
◦ Interferes with fungal DNA synthesis

 Fluconazole
◦ Decreased production of ergosterol
References
 "What Makes Cryptococcus Neoformans a Pathogen?" Centers for
Disease Control and Prevention. Web. 07 Mar. 2011.
<http://www.cdc.gov/ncidod/eid/vol4no1/buchanan.htm>.

 Lecture 9 – Fungal and Antifungal Therapy

 Lecture 31 – HIV and AIDS

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