Gastrointestinal Cryptococcosis in immunosuppressed patients

Area of Science:

• Medical Mycology
• Infectious Diseases
• Gastroenterology

Background:

• Cryptococcus neoformans is a fungus commonly found in avian-enriched soil.
• It typically causes disseminated disease, particularly meningoencephalitis, in immunocompromised individuals, including those with HIV/AIDS, on immunosuppressive therapy, or transplant recipients.
• Gastrointestinal cryptococcosis is an exceptionally rare manifestation, often presenting insidiously.

Purpose of the Study:

• To review the susceptible host categories for gastrointestinal cryptococcosis.
• To describe the clinical spectrum, diagnostic challenges, and treatment of this rare fungal infection.
• To emphasize the importance of early recognition in at-risk populations.

Main Methods:

• Literature review of case reports and studies on gastrointestinal cryptococcosis.
• Summary of clinical presentations, diagnostic findings (endoscopic and histopathological), and treatment outcomes.
• Analysis of host factors predisposing to infection.

Main Results:

• Gastrointestinal involvement by Cryptococcus neoformans is rare, with limited case reports.
• Symptoms can range from acute abdominal distress to indolent issues like dyspepsia, nausea, and diarrhea.
• Endoscopic findings may include ulcers, nodular lesions, and petechiae; diagnosis is often delayed and confirmed postmortem.

Conclusions:

• Gastrointestinal cryptococcosis requires a high index of suspicion in immunocompromised patients presenting with relevant symptoms.
• Prompt endoscopic evaluation and histopathological confirmation are essential for timely diagnosis.
• Early consideration and diagnosis are vital for improving the often-poor prognosis of this rare condition.