Cryptococcus albidus-induced Summer-type Hypersensitivity Pneumonitis

Abstract

We studied summer-type hypersensitivity pneumonitis believed to be induced by Cryptococcus albidus in the home environments of the patients. All patients had antibodies that were reactive to Cryptococcus neoformans and Trichosporon cutaneum in sera and bronchoalveolar lavage (BAL) fluids. Cryptococcus albidus strains were isolated from 62.5% of the patient home environments. Trichosporon cutaneum was found in none of the patient homes. To study local antibody production in the lung, we cultured BAL cells to measure anti-C. neoformans and anti-T. cutaneum antibodies in the culture supernatants by the ELISA method. IgG, IgA, and IgM anti-Cryptococcus and anti-Trichosporon antibodies were found in all culture supernatants. A significant correlation was observed in antibody binding activity between Cryptococcus and Trichosporon antigen. However, the amount of IgA and IgM antibody bound to C. neoformans was significantly higher than was bound to T. cutaneum. Most anti-Cryptococcus and anti-Trichosporon antibody was absorbed by C. albidus. Our results suggest that C. albidus may be an etiologic agent in most of the cases we studied, and that IgA and IgM antibody in BAL fluid may be secreted by plasma cells in the lung.

Non-neoformans Cryptococcal Infections: a Systematic Review

“…Chest radiograph findings included localized opacities, disseminated nodular infiltration mimicking miliary patterns, cavity lesions, hilar node enlargement, pleural fluid and diffuse bilateral opacification with or without a pattern similar to that seen in ARDS. Notable, the investigators of one report suggested that C. albidus may be an etiologic agent of summer-type hypersensitivity pneumonitis [47].…”

“…The mean duration of treatment for meningitis was 60 days [22], with 17 days (ranged 14-20 days) for fungemia [28,29] and 90 days for empyema [47]. One patient developed leukopenia and anemia as side effects of conventional amphotericin B (1 mg/kg/day) and therapy was switched to itraconazole [52].…”

Hypersensitivity pneumonitis from ordinary residential exposures.

“…In contrast, hypersensitivity pneumonitis from routine domestic exposures has been well described in other countries. The endemic Japanese summer-type hypersensitivity pneumonitis has been commonly associated with domestic exposure to Trichosporon cutaneum or Cryptococcus albidus (7), fungi that grow in rotting structural wood or wet tatami mats in residences (8). This kind of hypersensitivity pneumonitis has also been reported in South African residences (9).…”

Frecuencia de micosis en pacientes inmunosuprimidos de un hospital regional de la Ciudad de México

“…C albidus ha estado implicada en infecciones respiratorias severas, del sistema nervioso central y en fungemias. [29][30][31] Es posible que el hallazgo de esta levadura sea comúnmente subestimado y que esté jugando un papel patógeno importante, particularmente en pacientes inmunosuprimidos. como el que hemos presentado, constituyen el paso fundamental para detectar los problemas de salud de nuestra población.…”