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Perspectives on non-neoformans cryptococcal opportunistic infections
Nichole Smith1, Matthew Sehring1, Jefferson Chambers1
1UICOMP Internal Medicine Residency Program.
Journal of Community Hospital Internal Medicine Perspectives
|October 20, 2017
Summary
Non-neoformans Cryptococcus species, historically saprophytic, are increasingly causing opportunistic infections in humans. Risk factors include weakened immunity and corticosteroid use, necessitating a review of these emerging pathogens.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Microbiology
Background:
- Non-neoformans Cryptococcus species (e.g., C. laurentii, C. albidus) were traditionally considered exclusively saprophytic.
- Emerging evidence highlights their role as opportunistic pathogens causing human infections.
- This shift necessitates a re-evaluation of their clinical significance.
Purpose of the Study:
- To present a case of C. laurentii meningitis in an immunocompromised patient.
- To review the clinical spectrum and risk factors of non-neoformans Cryptococcus infections.
- To provide a comprehensive overview of pathogenesis and treatment.
Main Methods:
- Case report of C. laurentii meningitis.
- Literature review of 18 additional opportunistic infections attributed to C. laurentii.
- Synthesis of data on risk factors, pathogenesis, and treatment.
Main Results:
- C. laurentii was identified as the causative agent of meningitis in a critically ill patient on corticosteroids.
- Non-neoformans Cryptococcus species were implicated in 18 other cases, primarily affecting skin, bloodstream, and CNS.
- Impaired cell-mediated immunity, corticosteroid use, and invasive catheters are key risk factors.
Conclusions:
- Non-neoformans Cryptococcus species represent a growing threat in opportunistic infections.
- Recognition of risk factors is crucial for early diagnosis and management.
- Further research into pathogenesis and treatment strategies is warranted.
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