The genus Cryptococcus includes approximately 37 fungal species. Cryptococcus neoformans is the most common human pathogen. In British Columbia, a tropical version, Cryptococcus gatti was discovered in the coastal rain forest on Vancouver Island after several people became ill and one died.
Lung infection follows inhalation of cryptococci spores, which grow locally and can spread to other organs especially the brain. Diagnosis of brain infection is made after finding encapsulated yeasts in the cerebrospinal fluid stained with India ink and by culturing the organism from CSF. In AIDS patients CSF cultures are often positive. Bronchoscopy with bronchoalveolar lavage or biopsy are necessary to obtain samples from the lung for testing.
Harrison TS. Cryptococcus neoformans and cryptococcosis. J Infect. 2000;41:12-17
A profusion of fungi exists in the environment. Some fungi are able to cause an invasive infection in otherwise healthy individuals. Other fungi are opportunistic fungi that become invasive when immune defenses are compromised. Diagnosis of fungal infection is difficult. There are many problems when you try to connect a test result to a disease. Fungi are so abundant and there are so many varieties in every environment that it is seldom easy to pick just one cause among many. Fungi are inhaled and ingested. Foods always contain fungal spores and actively growing molds. Attempts to culture fungi often fail; only a small number grow in the culture media commonly used. Some new methods of detecting fungal DNA may be useful but development of reliable tests is slow and expensive.
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