CRYPTOCOCCOSIS

General Information

DEFINITION--A fungal disease that usually begins in the lung and may spread to other body parts. It is much more serious when there are underlying illnesses or risk factors. This condition has become more prevalent as an opportunistic disease since the onset of the AIDS epidemic.

BODY PARTS INVOLVED--Lung; central nervous system; kidney; bone; skin.

SEX OR AGE MOST AFFECTED--Most common in men between ages 40 and 60.

SIGNS & SYMPTOMS

• Severe headache.
• Stiff neck.
• Fever.
• Blurred vision.
• Mental disturbances, such as confusion, depression, agitation or inappropriate speech or dress.
• Cough.

CAUSES--Infection from the fungus, cryptococcus neoformans (also called filobasidiella neoformans). The fungus is acquired by breathing air that contains spores of this organism, which comes from soil contaminated by bird droppings. The serious, progressive, systemic form of this fungus disease is most apt to occur in persons who are seriously ill with other diseases or who are receiving immunosuppressive treatment.

> Illness that has lowered resistance--especially Hodgkin's disease--

or others, including: uremia; diabetes; chronic lung disease; tuberculosis; leukemia; or severe burns.

• Persons with HIV infection.

HOW TO PREVENT

• Obtain medical treatment for any of the serious illnesses listed as risks.
• Avoid bird roosts.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies of cerebrospinal fluid, blood and urine.
• X-rays of the chest and bones.

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for intensive care in severe cases.
• Non-AIDS patients with no pulmonary disease may require no treatment.

POSSIBLE COMPLICATIONS--This fungus can cause severe, debilitating illness. In rare cases, the fungi spread from the lungs throughout the body, causing skin ulcers and bone and kidney infections.

PROBABLE OUTCOME--

• Mild cases may require no treatment.
• Antifungal medicines are usually effective, but relapses occur.

How To Treat

GENERAL MEASURES--

• It is usually not necessary to isolate ill persons.
• Weigh daily and keep a weight chart. An unexplained weight loss might indicate that infection has spread.

MEDICATION--Your doctor may prescribe:

• Antifungal drugs. These are effective for skin, bone or kidney involvement and are life-saving for cryptococcal meningitis.
• Life-long suppression drugs.

ACTIVITY--If you have a mild form of the disease that does not require strong antifungal medication, rest in bed until the cough and fever disappear.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of cryptococcosis, especially a severe headache or stiff neck.
• The following occurs during treatment: Weight loss. Fever of 101F (38.3C) orally. Diarrhea that cannot be controlled. Severe headache and stiff neck.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.