Background
Cryptococcus spp. is a major cause of opportunistic infections in immunocompromised patients, primarily due to C. neoformans and C. gattii. There are occasional reports of other Cryptococcus species causing invasive human disease. However, their epidemiology and clinical significance are not fully defined. We sought to describe cases with cultures positive for Cryptococcus species other than C. neoformans and C. gattii.
Methods
A retrospective descriptive analysis of clinical and laboratory data of patients with cultures growing Cryptococcus species other than C. neoformans and C. gattii from 11/2011-02/2019 was performed. Three Mayo Clinic sites in Arizona, Florida, and Minnesota were included.
Results
From 176 cases with a culture growing Cryptococcus spp., 54 patients (30%) had a culture for Cryptococcus other than C. neoformans and C. gattii in the study timeframe. The most common species were magnus, laurentii, and ater. The organisms were isolated and identified in culture of bronchoalveolar lavage (11), skin (11), urine (7), oral (4), sinus (3), intraoperative soft tissue (3), sputum (2), synovial fluid (2), cerebrospinal fluid (2), and intravenous catheter (2), among others (7).
Only 8 (15%) cases were considered to be potentially pathogenic, with one case of invasive disease. Antifungal treatment was fluconazole, itraconazole, and griseofulvin, for a mean systemic antifungal duration of 42 days.
Conclusions
This large series of patients with Cryptococcus spp. other than C. neoformans and C. gattii suggests that these species rarely cause clinically significant infection in humans. Only one case of invasive disease was found.