Lecture of Cryptococcosis

2021-04-16 03:11 PM

The most common fungus in bird droppings is pigeon droppings because C neoformans are capable of using creatinine in guano as a nitrogen source.


Cryptococcus neoformans is a thick capsule of yeast. The disease is also known as European blastomycoses. Cryptococcus neoformans has two strains: C. neoformans var.neoformans with serotypes A and D, C. Neoformans var. gattii with serotypes B and C. 

Fungi can cause disease in humans and animals, occurring around the world. The disease was found to be associated with immunodeficiency in HIV, neoplasm-N, sarcoidosis, and in people taking immunosuppressants. Fungi often cause diseases of the skin, lungs and nervous system.

The most common fungus in bird droppings is pigeon faeces, since Neoformans is able to use creatinine in guano as a nitrogen source. In the faeces accumulated for a long time, there are many fungi because the fungus has good dry tolerance. In contrast, the new bird's faeces rarely see fungi because the rotting bacteria increases the pH, C. neoformans stop growing.

Clinical symptoms


Uncommon: Injuries usually occur on the legs, arms, and face. Lesions are well-defined, circular, or polyphonic ulcers, purple in the middle, pink around, and pus and fluid below. Lesions can spread and can then become necrotic and become a shallow, chronic progressive ulcer.

Lesions are nodular papules, papules or lumps, usually in the middle of a concave, a high ridge, often with pale black secretions covering the ulcer with fluid and blood, gums like acne. caseation. But in people with HIV, lesions like herpes or molluscum contagiosum.

Lesions from purulent abscesses, scarring, and scarring, wrinkled like cluster acne.


Fungi can enter the lungs by inhalation and cause pneumonia, which then manifests a low fever, cough, and discharge and is detected by radiographs.


When meninges are infected with cryptococcus, the first clinical symptoms are mild fever, headache, nausea, vomiting, dizziness, dizziness, and dizziness. In advanced progression, severe headache, stiff neck, high fever, cognitive disorder, memory loss, sometimes edema, eye irritation, cranial nerve paralysis, edema, coma, and death. In addition, the fungus can cause inflammation of the peritoneum, retina, liver, and bones.

Diagnostic tests

Direct test: staining with Chinese ink with swabs of fluid, pus from lesions or centrifugal sediment of brain fluid, marrow or skin biopsy stained with muciramin ... can show this yeast cell's bud stimulating size 8-12 mm, with a thick shell that can double the size of yeast cells. Fungal cells were detected in the organization when staining PAS or methenamine silver.

Culture: The fungus can grow when the specimens are on sabouraud or blood agar. At 370C, the colonies are colonized with cream of yeast with many small shoots.

Differential diagnosis

It is necessary to have a differential diagnosis with tuberculosis, other systemic fungal diseases, and cancer.


Often combined amphotericin B with 5 fluoroscopic, fluconazole, itraconazole, and ketoconazole can be used. In particular, fluconazole is often used as tablets and injections to treat cryptococcosis causing meningitis in HIV-infected patients.