What is Cryptococcal disease?

Cryptococcal disease is caused by the fungus Cryptococcus. The fungus is found worldwide in the environment in places such as decaying organic matter, trees, soil and bird droppings. The disease is mostly caused by two species of Cryptococcus: Cryptococcus neoformans and Cryptococcus gattii. People inhale the fungus from the air in the form of fungal spores. The fungus may remain inactive until the person’s immune system is weakened, such as in transplant recipients or persons with untreated HIV. People with intact immune systems can sometimes also get the disease, although these cases are less common.

When the fungus is active, it can spread to the brain and sometimes other organs through the bloodstream. Meningitis, or inflammation of the brain and spinal cord, is the most common form of disease that is caused by this fungus. Cryptococcal meningitis is a major cause of death in people living with HIV worldwide (second only to TB), despite the now widespread use of antiretroviral therapy (ART). It is also important to note that if a person knows that they have HIV infection, they should continue taking ART. If a person is diagnosed with cryptococcal meningitis, then the antifungal drugs amphotericin B, flucytosine and fluconazole can be prescribed to treat it. It is possible to diagnose and treat cryptococcosis early before it develops into life-threatening meningitis.