Introduction:
Cryptococcus gattii is a relatively new addition to the list of diseases native to British Columbia, first appearing in 1999. Disease caused by this fungus is uncommon but can be serious and result in pneumonia or meningitis. After exposure, it can take several months for the pathogen to incubate. Fortunately, only a few people exposed to the spores become ill, and there is much more uncertainty regarding more information about this fungus. C. gattii infections are most common in Papua New Guinea and Northern Australia. There have also been reports of cases elsewhere indicating that the pathogen has spread to India, Brazil, Vancouver Island in Canada, and Washington and Oregon in the United States.
What Are Cryptococcal Infections?
Cryptococcus gattii (C. gattii) causes the fungal infection cryptococcosis. Cryptococcosis most commonly affects the lungs or the central nervous system (brain and spinal cord), but it can also affect other parts of the body. Cryptococcal meningitis refers to brain infections caused by C. gattii and other types of Cryptococcus. C. gattii is found in soil and certain trees worldwide, primarily in tropical and subtropical regions. After inhaling the microscopic fungus from the environment, people can become infected with C. gattii.
What Are The Symptoms Of Cryptococcus gattii Infection?
The symptoms of Cryptococcus gattii infections appear between 2 to 13 months after breathing in the fungus, with an estimate of six to seven months. However, people can become infected as soon as two weeks after breathing in the fungus or as late as three years later. The actual incubation period of the infection is not well established yet. Most people exposed to the fungus will not become ill. C. gattii typically infects the lungs or the central nervous system (brain and spinal cord), but it can infect other parts of the body. The infection's symptoms vary depending on which body parts are affected.
1) In The Lungs: C.gatti infects the lungs and brings about pneumonia-like symptoms that are similar to that of any other condition. It includes:
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Cough.
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Fever.
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Chest pain.
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Breathlessness.
2) In The Brain: Cryptococcal meningitis is an infection caused by Cryptococcus gattii and other types of Cryptococcus that spreads from the lungs to the brain; however, one can have a brain infection without having a lung infection. Cryptococcal meningitis symptoms include:
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Headache.
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Confusion or behavioral changes.
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Neck ache.
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Fever.
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Vomiting and nausea.
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Light sensitivity.
Infection with C. gattii can also result in the development of cryptococcomas (fungal growths) in the lungs, skin, brain, or other organs, causing symptoms in the affected areas of the body.
How Are Cryptococcus gattii Infections Spread?
The infection is spread through inhalation of the fungus C.gattii from the environment. The fungus can be found in tropical and subtropical regions of the world, in the soil, and on trees (Australia, South America, Papua New Guinea, Mexico, Asia, Europe, and Africa). There is no human-to-human transmission of infection. Although animals can become infected, the infection cannot be transmitted from animals to humans. Infection occurs only through the inhalation of yeast cells or spores.
C. gattii enters the lungs after passing through the airway. C. gattii transforms into yeast due to the body's temperature, and the cells grow thick outer layers to protect themselves. By budding, yeasts divide and multiply. After infecting the lungs, C. gattii can spread through the bloodstream to infect other parts of the body, including the central nervous system.
Who Is At Risk Of Cryptococcus gattii Infections?
Anyone who has been in an area in which the fungus lives can become infected with C. gattii. However, various characteristics may make some people more susceptible to C. gattii infections than others in different parts of the world. In Australia and New Zealand, for example, C. gattii infections are thought to be more prevalent among:
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Healthy individuals.
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Males.
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Aboriginal peoples.
People in British Columbia, Canada, are more likely to contract the disease if they:
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Have weak immune systems, for example, as a result of:
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Cancer treatment.
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HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome).
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Corticosteroids and other immune-suppressing medications.
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Other lung conditions.
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Are over 50 years old.
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Tobacco use.
How Is Cryptococcus gattii Infection Diagnosed?
Since the disease is rare, the combination of symptoms can be unusual, and symptoms can be mild and last a long time before a patient seeks medical attention; Cryptococcus gattii infection is difficult to diagnose.
A healthcare provider diagnoses C. gattii infection by the medical and travel history, symptoms, physical examinations, and laboratory tests. The healthcare provider will then collect a sample of tissue or bodily fluid (such as blood, cerebrospinal fluid, or sputum) and send it to a laboratory for examination under a microscope, antigen testing, or culture. The doctor may also order tests such as a chest X-ray or a CT (computed tomography) scan of your lungs, brain, or other organs.
People must consult a doctor if they have symptoms similar to those described above, especially if they linger or are severe. People should notify their doctor if they live in or have visited an area infested with fungus.
How Are Cryptococcus gattii Infections Treated?
People infected with C. gattii must take antifungal medication for 6 to 12 months or longer. Treatment is usually based on the severity of the illness and the body parts affected.
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Fluconazole is typically used to treat asymptomatic C.gatti infections or mild-to-moderate pulmonary infections.
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Liposomal Amphotericin B combined with Flucytosine is the first-line treatment for people with severe lung infections or infections of the central nervous system (brain and spinal cord). Fluconazole is typically taken for an extended period of time after initial antifungal therapy to clear the infection. Some people will require lumbar punctures to relieve increased brain pressure. Corticosteroids may also be required in some cases.
The type of treatment, dosage, and duration of the antifungal treatment differs for pregnant women, children, and people in resource-limited settings. Surgery may also be needed to remove fungal growths (cryptococcomas).
How Are Cryptococcus gattii Infections Prevented?
Quitting smoking can reduce the risk of infection in smokers. There are no formal guidelines or vaccines for preventing C. gattii infection. Most people breathe in trace amounts of fungi daily without becoming ill. If one suspects that C. gattii causing their symptoms, they must consult a doctor as soon as possible.
Conclusion:
Cryptococcus gattii is a fungus that causes infections of the lungs, central nervous system, and other organs. Since the disease is rare, the combination of symptoms can be unusual, and symptoms can be mild and last a long time before a patient seeks medical attention. One must see the doctor if they have symptoms similar to those described above, especially if the symptoms linger or are severe. People should notify their doctor if they live in or have visited an area infested with fungus. These infections can be managed by medications such as Fluconazole or some cases, may require corticosteroid therapy.
