cryptococcosis /krip′tōkokō″sis/ , an infectious disease caused by the fungus Cryptococcus neoformans, which, after inhalation, spreads from the lungs to the brain and central nervous system, skin, skeletal system, and urinary tract. The disease occurs in all parts of the world, but 85% of the cases occur in North America, where it is most likely to afflict persons with immunodeficiencies such as human immunodeficiency virus (HIV) and middle-aged men in the southeastern United States. It is especially associated with breathing dust from pigeon droppings. Also called Busse-Buschke’s disease, European blastomycosis, torulosis. See also Cryptococcus. ▪ OBSERVATIONS: It is characterized by the development of nodules or tumors filled with a gelatinous material in visceral and subcutaneous tissues. Initial symptoms may include coughing or other respiratory effects because the lungs are a primary site of infection. After the fungus spreads to the meninges, neurological symptoms, including headache, blurred vision, and difficulty in speaking, may develop. The diagnosis is made by isolation and identification of the fungus in sputum, pus, or tissue biopsy specimens. ▪ INTERVENTIONS: Amphotericin B and fluconazole may be administered to control the infection. In patients with HIV, maintenance therapy with fluconazole may be indicated, but it does not affect survival and is not considered cost-effective.
