Cryptococcosis of the placenta in a woman with acquired immunodeficiency syndrome

Multiple microscopic colonies of encapsulated budding yeasts morphologically consistent with Cryptococcus sp were found in the maternal (intervillous) space of the placenta from a woman with AIDS. The patient contracted acquired immunodeficiency syndrome from her affected husband, who had died of the disease 3 years previously. The woman, who was in her sixth pregnancy at term, became symptomatic 1 month before delivery with malaise, oral thrush, and cervical lymphadenopathy. Tests for human immunodeficiency virus and serum hepatitis were negative. Cryptococcus neoformans was cultured in the blood and herpes simplex virus type II was isolated from the cervix. On the second postpartum day, the patient had difficulty breathing and died suddenly. Post-mortem examination disclosed a massive pulmonary embolus and disseminated infection with Cryptococcus organisms.