Clinical
Features |
Initial pulmonary infection is usually
asymptomatic. Most patients present with disseminated infection,
especially meningoencephalitis. In the United States, 85%
of cases occur in HIV-infected persons. |
Etiologic
Agent |
Cryptococcus neoformans. |
Reservoir |
C. neoformans var. neoformans
has been isolated from the soil worldwide, usually in association
with bird droppings. Less common etiologic agent, C. neoformans
var. gattii has been isolated from eucalyptus trees
in tropical and sub-tropical regions. |
Incidence |
0.4-1.3 cases per 100,000 in the
general population. Among persons with AIDS, the annual incidence
is 2-7 cases per 1,000. |
Sequelae |
Meningitis may lead to permanent
neurologic damage. Mortality rate is about 12%. |
Transmission |
Inhalation of airborne yeast cells
and/or basidiospores. |
Risk
Groups |
Immunocompromised persons, especially
those with HIV infection. |
Surveillance |
Active, population-based surveillance
in selected U.S. sites. No national surveillance exists. |
Challenges |
Developing a cost-effective prevention
strategy (although fluconazole is effective chemoprophylaxis
for persons with AIDS, it does not affect survival and is
not considered cost-effective). |
|
December 2003
|