Central Nervous System Cryptococcosis due to Cryptococcus gattii in the Tropics

Abstract

Purpose of Review Cryptococcosis of the central nervous system due to Cryptococcus gattii species complex is a serious mycosis with worldwide distribution but of great importance in the tropics. This article aims to review the progress made in these regions in the knowledge of this disease and its etiological agent. Recent Findings They can be summarized in the presence in apparently immunocompetent patients of autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF), which is a hidden risk factor for acquiring C. gattii infection; this finding strengthens the concept that C. gattii is an opportunistic pathogen. A greater knowledge of the clinical and molecular epidemiology of C. gattii infection and of the different environmental niches of this fungus in the tropics. The discovery of a new lineage of C. gattii , VGV, in environmental samples from Africa. Until now, the COVID-19 pandemic has not meant an increase in cryptococcosis cases. Summary Advances have been made in the identification of risk factors for cryptococcosis due to C. gattii as well as in the knowledge of its etiological agent and its relationship with the environment. Remarkably, there have been no significant achievements in diagnosis and treatment notwithstanding the documented importance.

COVID-19 Associated with Cryptococcosis: A New Challenge during the Pandemic

“…Therefore, efficient T cell responses to C. neoformans mannoproteins require recognition of terminal mannose groups by human macrophage mannose receptors. Individuals with compromised T cell function are susceptible to cryptococcosis [ 44 , 45 , 46 ]. In addition, the fungal pathogen C. neoformans invades the brain through a “Trojan Horse” mechanism, whereby the fungus crosses the blood–brain barrier as a transcellular passenger inside host phagocytes [ 47 , 48 ].…”

Incidencia De Infecciones Fúngicas Invasivas Asociadas a Covid-19

“…En personas con exposiciones prolongadas al hongo, se puede asociar el bloqueo del factor estimulante de colonias de granulocitos y macrófagos (GM-CSF) por autoanticuerpos como un factor de riesgo. Hasta el momento, el estándar de diagnóstico de criptococosis es la tinción negativa de líquido cefalorraquídeo (LCR), presencia de antígenos capsulares (por látex o ELISA) y PCR (Lizarazo & Castañeda, 2022).…”

Cerebral cryptococcoma successfully treated by isavuconazole in an immunocompetent patient: A case report

“…The latter is more globally distributed, but the former is responsible for approximately 95% of cases. Cryptococcal meningitis is the most common and severe presentation in immunosuppressed subjects, such as in late HIV infection and transplant patients, with an annual incidence of 223,000 cases and 180,000 deaths [1 , 2] . However, cryptococcosis may also occur in immunocompetent hosts, though in only 5% of cases.…”

“…The disease transmission occurs by inhalation of Cryptococcus spores, initially infecting the lungs. The infectious propagules may also spread to the central nervous system (CNS), causing cryptococcal meningitis, meningoencephalitis, and cerebral cryptococcomas [1] . The main manifestations are meningism (a triad of nuchal rigidity, photophobia, and headache), fever, and intracranial hypertension [3] .…”