A case of successful treatment of brain and lung cryptococcosis caused by Cryptococcus gattii

Clinical Characteristics of Patients with Cryptococcal Meningitis in Hokkaido: A Case Series

“…Furthermore, delayed exacerbations of cryptococcal meningitis owing to immunological mechanisms have been reported. The proposed mechanism involves inhibition of immune suppression by antifungal agents through the effects of glucuronoxylomannan, resulting in CSF vascular endothelial growth factor expression, increased vascular permeability and intracranial pressure, and blood-brain barrier (BBB) disruption ( 3 ). In contrast, in patient 9, who showed delayed exacerbation, anti-NMDAR antibodies were detected before antifungal treatment.…”

“…Nineteen species of Cryptococcus have been identified, including two that can cause infections in humans: C. neoformans (serotypes A and D) and C. gattii (serotypes B and C) ( 2 ). In Japan, C. neoformans type A is the causative organism in most cases of pulmonary infections and meningitis ( 3 ). C. gattii outbreaks have been reported in immunocompromised individuals, particularly in Australia and North America; however, some cases have recently been reported in Japan ( 4 , 5 ).…”

<i>Cryptococcus gattii</i> Genotype VGIIa Infection in an Immunocompetent Japanese Patient: A Case Report and Mini-review

“…Systemic features such as chills, fever and weight loss are also common symptoms. Although the clinical features of cryptococcosis caused by C. neoformans and C. gattii are similar, C. gattii is associated with large mass lesions of the lungs and brain and tends to be resistant to antifungal drugs ( 1 , 6 , 12 , 13 ). C. gattii requires lengthy antifungal treatment and, particularly in infections of the CNS, the aggressive management of increased intracranial pressure along with percutaneous lumbar drainage ( 1 , 2 , 13 , 17 ).…”

“…The second reported case was a 44-year-old man with untreated diabetes mellitus and no recent history of overseas travel (genotype: VGIIa) ( 5 ). The third reported case was a 34-year-old woman who had traveled to Korea and China, who had been treated for uterine cervical cancer one year previously (genotype: VGI) ( 12 ). The fourth reported case was an immunocompetent 33-year-old man with no history of overseas travel; however, he had been importing trees and soils from abroad to feed beetles (genotype: unknown) ( 13 ).…”