Cryptococcosis is a fungal infection caused by inhaling the fungus Cryptococcus neoformans, which is primarily found in soils enriched with pigeon droppings. In moist or desiccated pigeon dropping, Cryptococcus neoformans may remain viable for 2 years or longer.
Two varieties of Cryptococcus neoformans exist - neoformans and gattii. Cryptococcus neoformans var neoformans is the most common variety and mainly affects immunosuppressed patients such as those with HIV and AIDS. Cryptococcus neoformans var gattii is much less common but affects mainly immunocompetent (normal immune function) individuals. This variety is restricted to subtropical and tropical areas and the fungus found on eucalyptus trees and the surrounding air.
The most common cryptococcosis infections (Cryptococcus neoformans var neoformans) affect people with weakened immune systems, e.g. patients on high doses of corticosteroids, cancer chemotherapy patients, organ transplantation patients, and patients with acquired immune deficiency (AIDS) and human immunodeficiency virus infection (HIV). With the global emergence of AIDS, cryptococcosis is now one of the most common life-threatening fungal infections in these patients.
Infection is primarily through inhalation of Cryptococcus spores released from soil and bird droppings. It occurs in both humans and animals, but animal-to-human and human-to-human transmission via respiratory droplets has not been documented. Transmission via organ transplantation has been reported when infected donor organs were used. Infection via cuts through the skin is not common but may occur.
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