Cryptococcosis is sometimes called turolosis, the European yeast infection. It is a type of mycosis caused by a yeast-like fungus belonging to the class of imperfect fungi Cryptococcus neoformans. The fungus is infected by inhalation with pigeon faeces.
Cryptococcosis( European yeast infection ,torulosis ) is caused byCryptococcus neoformans , the fungus is present all over the world. The fungus is enveloped and multiplies by budding. Its greatest concentrations are recorded in the faeces of domestic birds: pigeons and chickens, especially in old and abandoned farm buildings. However, it is worth knowing that this yeast-like fungus was also found in fruits, fertilizers, dust, and even cow's milk, when the milk came from a cow suffering from cryptococcal mastitis. Cryptococcus can also be isolated from the skin and stools of he althy people. Most likely, the direct cause of infection is human contact with pigeon droppings, dried manure. The infection is most likely by inhalation, as a result of inhaling contaminated air.
Cryptococcosis: pathways of infection
Cryptococcosis belongs to the generalized mycoses. The disease caused by the fungus can take the form of organism, deep or superficial. In the first case, it attacks the central nervous system, lungs, and in the second, the skin and subcutaneous tissue. In people with a he althy immune system, Cryptococcus neoformans fungi are destroyed by granulocytes and pulmonary macrophages. The factor predisposing to infection is decreased immunity due to chronic disease, e.g. HIV infection, as well as anti-cancer therapy. In immunocompromised people, yeasts multiply in the lungs and travel through the bloodstream to the central nervous system. One of the determinants of pathogenicity is the polysaccharide coat, which prevents absorption by immune cells. In addition, Cryptococcus fungus has the ability to secrete melanin, which is deposited in the fungal cell wall and can protect it against the damaging effects of free radicals released by phagocytic cells - the first line of defense of the immune system.
Cryptococcosis: symptoms
The most common clinical formCryptococcal disease is a cryptococcal meningitis that may be subacute or chronic and develop over many months. The initial symptoms are visual disturbances, headaches. Then there are mental disorders. The last symptom is neck stiffness, coma. If the disease is not correctly diagnosed at this point and treatment is not undertaken, the patient is at risk of dying. In people with a he althy immune system, cryptococcosis causes mild changes in the lungs. In severely immunosuppressed patients treated with high doses of corticosteroids, cryptococcosis may appear in the form of changes in the skin, liver and other organs. Despite the fact that the lungs are the gateway of infection, the changes in them are often asymptomatic. With a long-lasting infection, changes may develop in the lungs that resemble tuberculosis on the radiographs. There are known cases of the formation of single granulomas - tumor-like lesions called cryptococcomas in the mediastinum.
Cryptococcosis treatment
The basis of cryptococcosis treatment is combined pharmacotherapy consisting in administering a combination of two drugs: amphotericin B and 5-fluorocytosine. Maintenance therapy with fluconazole is used for people with generalized or immunocompromised cryptococcosis, which reduces the risk of relapse.