Cryptococcal meningoencephalitis in immunocompetent patients: changing trends in Canada.

摘要

Cryptococcosis can range from asymptomatic pulmonary colonization to life-threatening meningitis and disseminated disease. Most infections occur in immunodeficiency states, though recent reports suggest that immunocompetent individuals may be at risk with some varieties of the yeast. Cryptococcus neo-formans var grubii and Cryptococcus neoformans var neoformans infect immunocompromised individuals,1 whereas Cryptococcus neoformans var gattii occurs predominantly in immunocompetent patients and has a strong male preponderance. This variety is found in the tropics in the decaying heartwood of a number of tree species and the outbreak in 2002 on Vancouver Island suggests this region to be the primary ecologic niche of the organism in Canada.2 To date, no cases of C neoformans var gattii in immunocompetent patients have been reported outside British Columbia. We describe clinical features of 3 such patients from Edmonton, Alberta.