1887

Chapter 11 : Epidemiology

Authors: Arturo Casadevall1, John R. Perfect2
VIEW AFFILIATIONS HIDE AFFILIATIONS
Affiliations: 1: Albert Einstein College of Medicine of Yeshiva University, Bronx, New York 10461-1602; 2: Department of Microbiology, Duke University Medical Center, Durham, North Carolina 27710
Content Type: Monograph
Publication Year: 1998

Category: Fungi and Fungal Pathogenesis

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Preview Magnify
Zoom in
Zoomout

Epidemiology, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555818241/9781555811075_Chap11-1.gif /docserver/preview/fulltext/10.1128/9781555818241/9781555811075_Chap11-2.gif

Abstract:

The epidemiology of cryptococcal infection is an important undertaking because it provides clues as to the pathogenesis of infections and permits an assessment of infection risk in a given population. Knowledge of how and where infects the human host is crucial for understanding the epidemiology and pathogenesis of infection. In a study the mean time that patients were on immunosuppressive therapy before the onset of cryptococcal infection was 48 months, and mortality was 30%. Among neoplastic disorders, disseminated cryptococcal infection has been historically associated with lymphoproliferative malignancies. Cryptococcosis is a relatively common infection among renal transplant patients despite the fact that renal transplantation has the lowest incidence of fungal infection among solid organ transplantation procedures. Insights on the epidemiology and pathogenesis of infection have resulted from comparative studies of cryptococcosis in various geographic regions. Researchers have interpreted the genetic diversity of strains as consistent with the theory of adaptive polymorphism, which predicts that the genetic diversity of a species is proportional to the diversity of ecological sites occupied.

Citation: Casadevall A, Perfect J. 1998. Epidemiology, p 351-380. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch11
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

References

/content/book/10.1128/9781555818241.chap11
1. Abrahan, M.,, V. Mathews,, A. Ganesh,, J. John,, and M. S. Mathews. 1997. Infection caused by Cryptococcus neoformans var. gattii serotype B in an AIDS patient in India. J. Med. Vet. Mycol. 35: 283– 284.
2. Allen, V. K.,, and L. Lowbeer. 1945. Rectal ulcers with perirectal fistula as a port of entrance for torula encephalitis. South. Med. J. 38: 564– 569.
3. Allende, M.,, R. A. Pizzo,, M. Horowitz,, H. I. Pass,, and T. J. Walsh. 1993. Pulmonary cryptococcosis presenting as metastases in children with sarcomas. Pediatr. Infect. Dis. J. 12: 240– 243.
4. Ammassari, A.,, A. Linzalone,, R. Muni,, G. Marasca,, G. Morace,, and A. Antinori. 1995. Fluconazole for primary prophylaxis of AIDS-associated cryptococcosis: a case-control study. Scand. J. Infect. Dis. 27: 235– 237.
5. Andreu, C. F.,, G. M. Machin,, L. P. A. Bernai,, R. Morales,, and C. A. Herrera. 1990. Cryptococcus neoformans var. neoformans isolated in Havana City. Mem. Inst. Oswaldo Cruz 85: 245.
6. Ansheng, L.,, K. Nishimura,, H. Taguchi,, R. Tanaka,, W. Shaoxi,, and M. Miyaji. 1993. The isolation of Cryptococcus neoformans from pigeon droppings and serotyping of naturally and clinically sourced isolates in China. Mycopathologia 124: 1– 5.
7. Arasteh, K.,, F. Staib,, G. Crosse,, U. Futh,, and M. L'age. 1996. Cryptococcosis in HIV infection in man: an epidimiological and immunological indicator? Zentralbl. Bakteriol. 284: 1563– 163.
8. Atkinson, A. J.,, and J. E. Bennett. 1968. Experience with a new skin test antigen prepared from Cryptococcus neoformans. Am. Rev. Respir. Dis. 97: 637– 643.
9. Bacellar, H.,, A. Muñoz,, E. N. Miller,, B. A. Cohen,, D. Besley,, O. A. Seines,, J. T. Becker,, and J. C. McArthur 1994. Temporal trends in the incidence of HIV-1-related neurologic diseases. Neurology 44: 1892– 1900.
10. Baker, R. D. 1976. The primary pulmonary lymph node complex of cryptococcosis. Am. J. Clin. Pathol. 65: 83– 92.
11. Bava, A. J.,, R. Negroni,, and M. Bianchi. 1993. Cryptococcosis produced by a urease negative strain of Cryptococcus neoformans. J. Med. Vet. Mycol. 31: 87– 89.
12. Benard, G.,, R. C. B. Gryscheck,, A. J. S. Duarte,, and M. A. Shikanai-Yasuda. 1996. Cryptococcosis as an opportunistic infection in immunodeficiency secondary to paracoccidioidomycosis. Mycopathologia 133: 65– 69.
13. Beng Bee, O.,, T. Tan,, and R. Pang. 1981. A case of primary cutaneous cryptococcosis successfully treated with miconazole. Arch. Dermatol. 117: 290– 291.
14. Bennett, J. E.,, K. J. Kwon-Chung,, and D. H. Howard. 1977. Epidemiologic differences among serotypes of Cryptococcus neoformans. Am. J. Epidemiol. 105: 582– 586.
15. Beyt, B. E.,, and S. R. Waltman. 1978. Cryptococcal endoththalmitis after corneal transplantation. N. Engl. J. Med. 298: 825– 826.
16. Bindford, C. H. 1941. Torulosis of the central nervous system. Review of recent literature and report of a case. Am. J. Clin. Pathol. 11: 242– 251.
17. Bloomfield, N.,, M. A. Gordon,, and D. F. Elmendorf, Jr. 1963. Detection of Cryptococcus neoformans antigen in body fluids by latex particle agglutination. Proc. Soc. Exp. Biol. Med. 114: 64– 67.
18. Bogaerts, J.,, H. Taelman,, J. Batungwanayo,, P. Van de Perre,, and D. Swinne. 1993. Two cases of HIV-associated cryptococcosis due to variety gattii in Rwanda. Trans. R. Soc. Trop. Med. Hyg. 63: 64.
19. Bonacini, M.,, J. Nussbaum,, and C. Ahluwalia. 1990. Gastrointestinal, hepatic, and pancreatic involvement with Cryptococcus neoformans in AIDS. J. Clin. Gastroenterol. 12: 296– 297.
20. Bottone, E. J.,, I. F. Salkin,, N. J. Hurd,, and G. P. Wormser. 1987. Serogroup distribution of Cryptococcus neoformans in patients with AIDS. J. Infect. Dis. 156: 242.
21. Brandt, M.,, S. L. Bragg,, and W. R. Pinner. 1993. Multilocus enzyme typing of Cryptococcus neoformans. J. Clin. Microbiol. 31: 2819– 2823.
22. Brandt, M.,, L. C. Hutwagner,, L. A. Klug,, W. S. Baughman,, D. Rimland,, E. A. Graviss,, R. J. Hamill,, C. Thomas,, P. G. Pappas,, A. L. Reingold,, and R. W. Pinner. 1996. Molecular subtype distribution of Cryptococcus neoformans in four areas of the United States. J. Clin. Microbiol. 34: 912– 917.
23. Brandt, M. E.,, L. C. Hutwagner,, R. J. Kuykendall,, R. W. Pinner, and The Cryptococcal Disease Active Surveillance Group. 1995. Comparison of multilocus enzyme electrophoresis and random amplifed polymorphic DNA analysis for molecular sub-typing of Cryptococcus neoformans. J. Clin. Microbiol. 33: 1890– 1895.
24. Brandt, M. E.,, M. A. Pfaller,, R. A. Hajjeh,, E. A. Graviss,, J. Rees,, E. D. Spitzer,, R. W. Pinner,, and L. W. Mayer. 1996. Molecular subtypes and antifungal susceptibilities of serial Cryptococcus neoformans isolates in human immunodeficiency virus-associated cryptococcosis. J. Infect. Dis. 174: 812– 820.
25. Brandt, M. E.,, M. A. Pfaller,, R. A. Hajjeh,, and R. W. Pinner. 1995. DNA subtypes and antifungal susceptibilities in recurrent cryptococcosis, abstr. E-77. Program Abstr. 35th Intersci. Conf. Antimicrob. Agents Chemother., 1995.
26. Campbell, G. D.,, R. D. Currier,, and J. F. Busey. 1981. Survival in untreated cryptococcal meningitis. Neurology 31: 1154– 1157.
27. Casadevall, A.,, L. Freundlich,, L. Marsh,, and M. D. Scharff. 1992. Extensive allelic variation in Cryptococcus neoformans. J. Clin. Microbiol. 30: 1080– 1084.
28. Casadevall, A.,, J. Mukherjee,, Y. RuiRong,, and J. Perfect 1994. Management of Cryptococcus neoformans contaminated needle injuries. Clin. Infect. Dis. 19: 951– 953.
29. Casadevall, A.,, and A. Spitzer. 1995. Involvement of multiple Cryptococcus neoformans strains a single episode of cryptococcosis and reinfection with novel strains in recurrent infection demonstrated by random amplification of polymorphic DNA and DNA fingerprinting, J. Clin. Microbiol. 33: 1682– 1683.
30. Casadevall, A.,, E. D. Spitzer,, D. Webb,, and M. G. Rinaldi. 1993. Susceptibilities of serial Cryptococcus neoformans isolates from patients with recurrent cryptococcal meningitis to amphotericin B and fluconazole. Antimicrob. Agents Chemother. 37: 1383– 1386.
31. Chariyalertsak, S.,, T. Sirisanthana,, K. Supparatpinyo,, and K. E. Nelson. 1996. Seasonal variation of disseminated Penicillium marneffei infections in Northern Thailand: a clue to the reservoir? J. Infect. Dis. 173: 1490– 1493.
32. Chen, E.,, B. P. Currie,, L.-C. Chen,, S. G. Spitzer,, E. D. Spitzer,, and A. Casadevall. 1995. Genetic relatedness of Cryptococcus neoformans clinical isolates grouped with the repetitive DNA probe CNRE-1. J. Clin. Microbiol. 33: 2818– 1822.
33. Chen, S. C. A.,, A. G. Brownlee,, T. C. Sorrell,, P. Ruma,, D. H. Ellis,, T. Pfeiffer,, B. R. Speed,, and G. Nimmo. 1996. Identification by random amplification of polymorphic DNA of a common molecular type of Cryptococcus neoformans var. neoformans in patients with AIDS or other immunosuppressive conditions. J. Infect. Dis. 172: 754– 758.
34. Cherniak, R.,, L. C. Morris,, T. Belay,, E. D. Spitzer,, and A. Casadevall. 1995. Variation in the structure of glucuronoxylomannan in isolates from patients with recurrent cryptococcal meningitis. Infect. Immun. 63: 1899– 1905.
35. Chuck, S. L.,, and M. A. Sande. 1989. Infections with Cryptococcus neoformans in the acquired immunodeficiency syndrome. N. Engl. J. Med. 321: 794– 799.
36. Clark, R. A.,, D. Greer,, W. Atkinson,, G. T. Valianis,, and N. Hyslop. 1990. Spectrum of Cryptococcus neoformans infection on 68 patients infected with human immunodeficiency virus. Rev. Infect. Dis. 12: 768– 777.
37. Clumeck, N.,, J. Sonnet,, H. Taelman,, E. Mascart-Lemont,, M. De Bruyère,, P. Vande-perre,, J. Dasnoy,, L. Marcelis,, M. Lamy,, C. Jonas,, L. Eyckmans,, H. Noel,, M. Vanhaeverbeek,, and J.-P. Butzler. 1984. Acquired immunodeficiency syndrome in African patients. N. Engl. J. Med. 320: 492– 497.
38. Collins, V. P.,, A. Gellhorn,, and J. R. Trimble. 1995. The coincidence of cryptococcosis and disease of the reticulo-endothelial and lymphatic systems. Cancer 4: 883– 889.
39. Cox, L. B.,, and J. C. Tolhurst. 1946. Human Torulosis. Melbourne University Press, Melbourne.
40. Crowe, S. M.,, J. B. Carlin,, K. I. Stewart,, C. R. Lucas,, and J. F. Hoy. 1991. Predictive value of CD4 lymphocyte numbers for the development of opportunistic infections and malignancies in HIV-infected persons, J. Acquired Immune Defic. Syndr. 4: 770– 776.
41. Currie, B.,, H. Sanati,, A. S. Ibrahim,, J. E. Edwards,, A. Casadevall,, and M. A. Ghannoum. 1995. Sterol compositions and susceptibilities to amphotericin B of environmental Cryptococcus neoformans isolates are changed by murine passage. Antimicrob. Agents Chemother. 39: 1934– 1937.
42. Currie, B. P.,, and A. Casadevall. 1994. Estimation of the prevalence of cryptococcal infection among HIV infected individuals in New York City. Clin. Infect. Dis. 19: 1029– 1033.
43. Currie, B. P.,, L. F. Freundlich,, and A. Casadevall. 1994. Restriction fragment length polymorphism analysis of Cryptococcus neoformans isolates from environmental (pigeon excreta) and clinical isolates in New York City. J. Clin. Microbiol. 32: 1188– 1192.
44. Daly, J. S.,, K. A. Porter,, F. K. Chong,, and R. J. Robillard. 1990. Disseminated, nonmeningeal gastrointestinal cryptococcal infection in an HIV-negative patient. Am. J. Gastroenterol. 85: 1421– 1424.
45. De Wytt, C.,, P. L. Dikson,, and G. Holt. 1982. Cryptococcal meningitis. A review of 32 years experience. J. Neurol. Sci. 53: 283– 292.
46. DeShaw, M.,, and L.-A. Pirofski. 1995. Antibodies to the Cryptococcus neoformans capsular glucuronoxylomannan are ubiquitous in serum from HIV+ and HIV- individuals. Clin. Exp. Immunol. 99: 425– 432.
47. Desmet, P.,, K. D. Kayembe,, and C. De Vroey. 1989. The value of cryptococcal antigen screening among HIV-positive/AIDS patients in Kinshasa, Zaire. AIDS 3: 77– 78.
48. Dev, D.,, G. S. Basran,, D. Slater,, P. Taylor,, and M. Wood. 1994. Consider HIV negative immunodeficiency in cryptococcosis. Br. Med. J. 308: 1436.
49. Devi, S. J. N.,, P. G. Reddy,, C. A. Lyman,, T. I. Walsh,, C. E. Frasch,, and A. C. Bush. 1996. Immimohistochemical properties of a polysaccharide antigen of Trichosporon beigelii that cross-reacts with the capsular polysaccharide of Cryptococcus neoformans. Immunol. Infect. Dis. 6: 87– 92.
50. Diamond, R. D.,, and J. E. Bennett 1974. Prognostic factors in cryptococcal meningitis. Ann. Intern. Med. 80: 176– 181.
51. Dixon, D. M.,, M. M. McNeil,, M. L. Cohen,, B. G. Gellin,, and J. R. LaMontagne. 1996. Fungal infections. A growing threat. Public Health Rep. 111: 226– 235.
52. Driver, J. A.,, C. A. Saunders,, B. Heinze-Lacey,, and A. M. Sugar. 1995. Cryptococcal pneumonia in AIDS: is cryptococcal meningitis preceded by clinically recognizable pneumonia. J. Acquired Immune Defic. Syndr. 9: 168– 171.
53. Dromer, E.,, S. Mathoulin,, B. Dupont,, and A. Laporte. 1996. Epidemiology of cryptococcosis in France: a 9-year survey (1985-1993). Clin. Infect. Dis. 23: 82– 90.
54. Dromer, F.,, S. Mathoulin,, B. Dupont,, L. Letenneur,, and O. Ronin. 1996. Individual and environmental factors associated with infection due to Cryptococcus neoformans serotype D. Clin. Infect. Dis. 23: 91– 96.
55. Dromer, F.,, O. Ronin,, and B. Dupont. 1992. Isolation of Cryptococcus neoformans var. gattii from an Asian patient in France: evidence for dormant infection in healthy subjects. J. Med. Vet. Mycol. 30: 395– 397.
56. Dromer, E.,, A. Vanna,, O. Ronin,, S. Mathoulin,, and B. Dupont 1994. Molecular typing of Cryptococcus neoformans serotype D clinical isolates. J. Clin. Microbiol. 32: 2364– 2371.
57. Drutz, D. J.,, M. Huppert,, S. H. Sun,, and W. L. McGuire. 1981. Human sex hormones stimulate the growth and maturation of Coccidioides immitis. Infect. Immun. 32: 897– 907.
57a. Dummer, I. M.,, C. G. Montero,, B. P. Griffith,, R. L. Hardesty,, I. L. Paradis,, and M. Ho. 1986. Infections in heart-lung transplant recipients. Transplantation 41: 725– 728.
58. Duncan, R. A.,, C. Fordhan von Reyn,, G. M. Alliegro,, Z. Toosi,, A. M. Sugar,, and S. M. Levitz. 1993. Idiopathic CD4+ T-lymphocytopenia—four patients with opportunistic infections and no evidence of HIV infection. N. Engl. J. Med. 328: 393– 398.
59. Duperval, R.,, P. E. Hermans,, N. S. Brewer,, and G. S. Roberts. 1977. Cryptococcosis, with emphasis on the significance of isolation of Cryptococcus neoformans from the respiratory tract. Chest 72: 13– 19.
60. Edwards, V. E.,, J. M. Sutherland,, and J. H. Tyrer. 1970. Cryptococcosis of the central nervous system. Epidemiological, clinical, and therapeutic features. J. Neurol . Neuro-surg. Psychiatr. 33: 415– 425.
61. Ellis, D.,, and T. J. Pfeiffer. 1992. The ecology of Cryptococcus neoformans. Eur. J. Epidemiol. 8: 321– 325.
62. Ellis, D. H. 1987. Cryptococcus neoformans var. gattii in Australia, ƒ. Clin. Microbiol. 25: 430– 431.
63. Ellis, D. H.,, and T. J. Pfeiffer. 1990. Ecology, life cycle, and infectious propagule of Cryptococcus neoformans. Lancet 336: 923– 925.
64. Ellis, D. H.,, and T. J. Pfeiffen 1990. Natural habitat of Cryptococcus neoformans var. gattii. J. Clin. Microbiol. 28: 1642– 1644.
65. Emanuel, B.,, E. Ching,, A. D. Leiberman,, and M. Goldin. 1961. Cryptococcus meningitis in a child successfully treated with amphotericin B, with a review of the pediatric literature. J. Pediatr. 59: 577– 591.
66. Emmons, W. W., III,, S. Luchsinger,, and L. Miller. 1995. Progressive pulmonary cryptococcosis in a patient who is immunocompetent. South. Med. J. 88: 657– 660.
67. Eng, R. H. K.,, E. Bishburg,, S. M. Smith,, and R. Kapila. 1986. Cryptococcal infections in patients with acquired immune deficiency syndrome. Am. J. Med. 81: 19– 23.
68. Feldmesser, M.,, and A. Casadevall. 1997. Effect of serum IgGl against murine pulmonary infection with Cryptococcus neoformans. J. Immunol. 158: 790– 799.
69. Fisher, D.,, J. Burrow,, D. Lo,, and B. Currie. 1993. Cryptococcus neoformans in tropical northern Australia: predominantly variant gattii with good outcomes. Aust. N.Z. J. Med. 23: 678– 682.
70. Flickinger, F. W.,, M. D. Sathyanarayana,, J. E. Whote,, E. J. Stinger,, and R.-M. Fincher. 1993. Cryptococcocal pneumonia presenting as an infiltrative mass simulating carcinoma in an immunocompetent host: plain film, CT, and MRI. South. Med. J. 86: 450– 452.
71. Franzot, S. P.,, J. S. Hamdan,, B. P. Currie,, and A. Casadevall. 1997. Molecular epidemiology of Cryptococcus neoformans in Brazil and the United States: evidence for both local genetic differences and a global clonal population structure. J. Clin. Microbiol. 35: 2243– 2251.
71a. Freeman, W. 1931. Torula infection of the central nervous system. J. Psychol. Neurol. 43: 236– 345.
72. Friedman, G. D. 1983. The rarity of cryptococcosis in Northern California: the 10-year experience of a large defined population. Am. J. Epidemiol. 117: 230– 234.
73. Friedman, M.,, A. Brenski,, and L. Taylor. 1994. Treatment of aphthous ulcers in AIDS patients. Laryngoscope 104: 566– 570.
74. Fries, B. C.,, F. Chen,, B. P. Currie,, and A. Casadevall. 1996. Karyotype instability in Cryptococcus neoformans infection. J. Clin. Microbiol. 34: 1531– 1534.
75. Frisch, M.,, and D. R. Gnepp. 1995. Primary cryptococcal infection of the larynx: report of a case. Otolaryngol. Head Neck Surg. 113: 477– 480.
76. Fromtling, R. A.,, A. M. Fromtling,, S. Staib,, and S. Muller. 1981. Effect of uremia on lymphocyte transformation and chemiluminescence by spleen cells of normal and Cryptococcus neoformans-miected mice. Infect. Immun. 32: 1073– 1078.
77. Gallis, H. A.,, R. A. Berman,, T. R. Cate,, J. D. Hamilton,, J. C. Gunnells,, and D. L. Stickel. 1975. Fungal infection following renal transplantation. Arch. Intern. Med. 135: 1163– 1171.
78. Gendel, B. R.,, M. Ende,, and S. L. Norman. 1950. Cryptococcosis. A review with special reference to apparent association with Hodgkin's disease. Am. J. Med. 9: 343– 355.
79. Gezuele, E.,, L. Calegari,, D. Sanabria,, G. Davel,, and E. Civila. 1993. Isolation in Uruguay of Cryptococcus neoformans var. gattii from a nest of the wasp Polybia occidental. Rev. Voer. Micol. 10: 5– 6.
80. Glaser, J. B.,, and A. Garden. 1985. Inoculation of cryptococcosis without transmission of the acquired immunodeficiency syndrome. N. Engl. J. Med. 313: 266.
81. Goldman, D.,, S. C. Lee,, and A. Casadevall. 1994. Pathogenesis of pulmonary Cryptococcus neoformans infection in the rat. Infect. Immun. 62: 4755– 4761.
82. Goldstein, E.,, and O. N. Rambo. 1962. Cryptococcal infection following steroid therapy. Ann. Intern. Med. 56: 114– 120.
83. Gordon, M. A.,, and D. K. Vedder. 1966. Serologic tests in diagnosis and prognosis of cryptococcosis. JAMA 197: 131– 137.
84. Granier, E.,, J. Kanitakis,, C. Hermier,, Y. Y. Zhu,, and J. Thivolet. 1987. Localized cutaneous cryptococcosis successfully treated with ketoconazole. J. Am. Acad. Dermatol. 16: 243– 249.
85. Gupta, S.,, M. Ellis,, T. Cesario,, M. Ruhling,, and B. Vayuvegula. 1987. Disseminated cryptococcal infection in a patient with hypogammaglobulinemia and normal T-cell function. Am. J. Med. 82: 129– 131.
86. Hamagami, S.,, T. Miyagawa,, T. Ochi,, I. Tsuyuguchi,, and S. Kishimoto. 1992. A raised level of soluble CD8 in bronchoalveolar lavage fluid in summer-type hypersensitivity pneumonitis in Japan. Chest 101: 1044– 1049.
87. Haugen, R. K.,, and R. D. Baker. 1954. The pulmonary lesions in cryptococcosis with special reference to subpleural nodules. Am. J. Clin. Pathol. 24: 1381– 1390.
88. Haynes, K. A.,, D. J. Sullivan,, D. C. Coleman,, J. C. K. Clarke,, R. Emilianus,, and K. J. Cann. 1995. Involvement of multiple Cryptococcus neoformans strains in a single episode of cryptococcosis and reinfection with novel strains in recurrent infection demonstrated by random amplification of polymorphic DNA and DNA fingerprinting. J. Clin. Microbiol. 33: 99– 102.
89. Hibbeid, P. L.,, and R. H. Rabin. 1994. Clinical aspects of fungal infections in organ transplant patients. Clin. Infect. Dis. 19( Suppl. 1): S33– S44.
90. Houpt, D. C.,, G. S. T. Pfrommer,, B. J. Young,, T. A. Larson,, and T. R. Kozel. 1994. Occurrences, immunoglobulin classes, and biological activities of antibodies in normal human serum that are reactive with Cryptococcus neoformans glucuronoxylomannan. Infect. Immun. 62: 3857– 2864.
91. Hsu, M. M.,, J.-C. Chang,, K. Yokoyama,, K. Nishimura,, and M. Miyaji. 1994. Serotypes and mating types of clinical strains of Cryptococcus neoformans in Taiwan. Myco-pathologia 125: 77– 81.
92. Huffnagle, G. B.,, J. L. Yates,, and M. F. Lipscomb. 1991. Immunity to pulmonary Cryptococcus neoformans infection requires both CD4+ and CD8+ T cells. J. Exp. Med. 173: 793– 800.
93. Hunter, P. R.,, and C. A. M. Fraser. 1990. Application of the theory of adaptive polymorphism to the ecology and epidemiology of pathogenic yeasts. Appl. Environ. Microbiol. 56: 2219– 2222.
94. Hutto, J. O.,, C. S. Bryan,, F. L. Greene,, C. J. White,, and J. I. Gallin. 1988. Cryptococcosis of the colon resembling Crohn's disease in a patient with the hyperimmuno-globulinemia E-recurrent infection (Job's) syndrome. Gastroenterology 94: 808– 812.
95. Iarobellis, F. W.,, M. I. Jacobs,, and R. P. Cohen. 1984. Primary cutaneous cryptococcosis. Arch. Dermatol. 23: 673– 675.
96. Imwidthaya, P. 1994. One year's experience with Cryptococcus neoformans in Thailand. Trans. R. Soc. Trans. Med. Hyg. 88: 208.
97. Imwidthaya, P.,, P. Dithaprasop,, and C. Egtasaeng. 1989. Clinical and environmental isolates of Cryptococcus neoformans in Bangkok (Thailand). Mycopathologia 108: 65– 67.
98. Jabbouç, N.,, J. Reyes,, S. Kusne,, M. Martin,, and J. Fung. 1996. Cryptococcal meningitis after liver transplantation. Transplantation 61: 156– 167.
99. Jacobs, D. H.,, A. M. Macher,, R. Handler,, J. E. Bennett,, M. J. Collen,, and J. I. Gallin. 1984. Esophageal cryptococcosis in a patient with the hyperimmunoglobulin E-recurrent infection (Job's) syndrome. Gastroenterology 87: 201– 203.
100. John, G. T.,, M. Mathew,, E. Snehalatha,, V. Anandi,, A. Date,, C. K. Jacob,, and J. C. M. Shastry. 1994. Cryptococcosis in renal allograft recipients. Transplantation 58: 855– 856.
101. Jones, E. L. 1927. Torula infection of the nasopharynx. South. Med. J. 20: 120– 126.
102. Kanj, S. S.,, K. Welty-Wolf,, J. Madden,, V. Tapson,, M. A. Baz,, R. D. Davis,, and J. R. Perfect. 1996. Fungal infections in lung and heart-lung transplant recipients. Medicine 75: 142– 156.
103. Kapend'a, K.,, K. Komichelo,, D. Swinne,, and J. Vandepitte. 1987. Meningitis due to Cryptococcus neoformans biovar gattii in a Zairean AIDS patient. Eur. J. Clin. Microbiol. 6: 320– 321.
104. Kaplan, M. H.,, P. P. Roses,, and D. Armstrong. 1977. Cryptococcosis in a cancer hospital. Clinical and pathological correlates in forty-six patients. Cancer 39: 2265– 2274.
105. Katlama, C.,, C. Leport,, F. Brun-Vezinet,, C. Rouzioux,, D. Vittecoq,, T. Lambolez,, P. Lebras,, P. Petitprez,, G. Offendstadt,, F. Vachon,, J. L. Vilde,, J. P. Coulaud,, and A. G. Saimot 1984. Acquired Immunodeficiency syndrome (AIDS) in Africans. Ann. Soc. Belg. Med. Trop. 64: 379– 389.
106. Kaufman, L.,, and S. Blumer. 1977. Cryptococcosis: the awakening giant, abstr. 176-182. Proc. Fourth International Conference on the Mycoses. PAHO Scientific Publication no. 356.
107. Keller, R. G.,, G. S. Pfrommer,, and T. R. Kozel. 1994. Occurrences, specificities, and functions of ubiquitous antibodies in human serum that are reactive with the Cryptococcus neoformans cell wall. Infect. Immun. 62: 215– 220.
108. Keye, J. D.,, and W. E. Magee. 1956. Fungal diseases in a general hospital. Am. J. Clin. Pathol. 26: 1235– 1253.
109. Knight, F. R.,, D. W. Mackenzie,, B. G. Evans,, K. Porter,, N. J. Barrett,, and G. C. White. 1993. Increasing incidence of cryptococcosis in the United Kingdom. J. Infect. 27: 185– 191.
110. Kohno, S.,, A. Varma,, K. J. Kwon-Chung,, and K. Hara. 1994. Epidemiology studies of clinical isolates of Cryptococcus neoformans of Japan by restriction fragment length polymorphism, J. Jpn. Assoc. Infect. Dis. 68: 1512– 1517.
111. Kovacs, J. A.,, A. A. Kovacs,, M. Polis,, W. C. Wright,, V. J. Gill,, C. U. Tuazon,, E. P. Gelmann,, H. C. Lane,, R. Longfield,, G. Overturf,, A. M. Mâcher,, A. S. Fauci,, J. E. Parrillo,, J. E. Bennett,, and H. Masur. 1985. Cryptococcosis in the acquired immunodeficiency syndrome. Ann. Intern. Med. 103: 533– 538.
112. Krick, J. A. 1981. Familial cryptococcal meningitis. J. Infect. Dis. 143: 133.
113. Kwon-Chung, K. J.,, and J. E. Bennett. 1984. Epidemiologic differences between the two varieties of Cryptococcus neoformans. Am. J. Epidemiol. 120: 123– 130.
114. Kyong, C. U.,, G. Virella,, H. H. Fudenberg,, and C. P. Darby. 1978. X-linked immunodeficiency with increased IgM: clinical, ethnic, and immunologic heterogeneity. Pediatr. Res. 12: 1024– 1026.
115. Lazer, M. S.,, B. Wanke,, and M. M. Nishikawa. 1993. Isolation of both varieties of Cryptococcus neoformans from saprophytic sources in the city of Rio de Janeiro, Brazil. J. Med. Vet. Mycol. 31: 449– 454.
116. Leggiadro, R. J.,, F. F. Barrett,, and W. T. Hughes. 1992. Extrapulmonary cryptococcosis in immunocompromised infants and children. Pediatr. Infect. Dis. J. 11: 43– 47.
117. Leggiadro, R. J.,, M. W. Kline,, and W. T. Hughes. 1991. Extrapulmonary cryptococcosis in children with acquired immunodeficiency syndrome. Pediatr. Infect. Dis. J. 10: 658– 662.
118. Levin, E. A. 1937. Torula infection of the central nervous system. Arch. Intern. Med. 59: 667– 684.
119. Lewis, J. L.,, and S. Rabinovich. 1972. The wide spectrum of cryptococcal infections. Am. J. Med. 53: 315– 322.
120. Littman, M. L. 1959. Cryptococcosis (torulosis). Am. J. Med. 27: 976– 998.
121. Littman, M. L. 1968. Cryptococcosis: current status. Am. J. Med. 45: 922– 932.
122. Littman, M. L.,, and S. S. Schneierson. 1959. Cryptococcus neoformans in pigeon excreta in New York City. Am. J. Hyg. 69: 49– 59.
123. Littman, M. L.,, and L. E. Zimmerman. 1956. Cryptococcosis, Torulosis or European Blastomycosis. Grune & Stratton, New York.
124. Lo, D. 1976. Cryptococcosis in the northern territory. Med. J. Aust. 27: 825– 826.
125. Mabee, C. L.,, S. W. Mabee,, R. B. Kirkpatrick,, and S. L. Koletar. 1995. Cirrhosis: a risk factor for cryptococcal peritonitis. Am. J. Gastroenterol. 90: 2042– 2045.
126. Magee, J. T.,, C. Philpot,, J. Yang,, and I. K. Hosein. 1994. Pyrolysis typing of isolates from a recurrence of systemic cryptococcosis, J. Med. Microbiol. 40: 165– 169.
127. Maher, D.,, and H. Mwandumba. 1994. Cryptococcal meningitis in Lilongwe and Blantyre, Malawi. J. Infect. 28: 59– 64.
128. Manfredi, R.,, G. Rezza,, V. G. Coronado,, A. C. Lepri,, O. V. Coronado,, A. Mastroianni,, and F. Chiodo. 1995. Is AIDS-related cryptococcosis more frequent among men? AIDS 9: 397– 398.
129. Mansoor, G. A.,, and D. B. Ornt. 1997. Cryptococcal peritonitis in peritoneal dialysis patients: a case report. Clin. Nephrol. 41: 230– 232.
130. Mare, M.,, M. T. Sartori,, M. Carretta,, A. Bertaggia,, and A. Girolami. 1990. Thino-phyma-like cryptococcal infection as an early manifestation of AIDS in a hemophilia B patient. Acta Haematol. 84: 101– 103.
131. Marquis, G.,, S. Montplaisir,, M. Pelletier,, S. Mousseau,, and P. Auger. 1985. Genetic resistance to murine cryptococcosis: increased susceptibility in the CBA/N XID mutant strain of mice. Infect. Immun. 47: 282– 287.
132. Martinez, A. J.,, M. Sell,, T. Mitrovics,, G. Stoltenburg-Didinger,, J. R. Iglesias-Rozas,, M. A. Giraldo-Velasquez,, G. Gosztonyi,, V. Schneider,, and J. Cervos-Navarro. 1995. The neuropathology and epidimiology of AIDS. A Berlin experience. A review of 200 cases. Pathol. Res. Pract. 191: 427– 443.
133. McGehee, J. L.,, and I. D. Michelson. 1926. Torula infection in man, report of a case. Surg. Gynecol. Obstet. 42: 803– 808.
134. McManus, E. J.,, and J. M. Jones. 1985. Detection of a Trichosporon beigelii antigen cross-reactive with Cryptococcus neoformans capsular polysaccharide in serum from a patient with disseminated Trichosporon infection. J. Clin. Microbiol. 21: 681– 685.
135. McNeill, J. I.,, and V. L. Kan. 1995. Decline in the incidence of cryptococcosis among HIV-infected patients. J. Acquired Immune Oefic. Syndr. Hum. Retrovirol. 9: 206– 208.
136. McNulty, A.,, J. M. Kaldoç,, A. M. McDonald,, K. Baumgart,, and D. A. Cooper. 1994. Acquired immunodeficiency without evidence of HIV infection: national retrospective survey. Br. Med. J. 308: 825– 826.
138. Miyagawa, T.,, S. Hamagami,, T. Ochi,, T. Osugi,, M. Kikui,, and H. Takahashi. 1982. Japanese summer-type hypersensitivity pneumonitis: studies using Cryptococcus antigen. Clin. Allergy 12: 343– 354.
139. Miyagawa, T.,, T. Ochi,, and H. Takahashi. 1978. Hypersensitivity pneumonitis with antibodies to Cryptococcus neoformans. Clin. Allergy 8: 501– 509.
140. Mody, C. H.,, G. B. Toews,, and M. F. Lipscomb. 1988. Cyclosporin A inhibits the growth of Cryptococcus neoformans on a murine model. Infect. Immun. 56: 7– 12.
141. Mody, C. H.,, G. B. Toews,, and M. F. Lipscomb. 1989. Treatment of murine cryptococcosis with cyclosporin-A in normal and athymic mice. Am. Rev. Respir. Dis. 139: 8– 13.
142. Murphy, J. J.,, F. D. McDonald,, M. Dawson,, A. Reite,, J. Turcotte,, and R. Fekety. 1976. Factors affecting the frequency of infection in renal transplant recipients. Arch. Intern. Med. 136: 670– 677.
143. Newberry, W. M.,, J. Walter,, J. W. Chandler,, and F. E. Tosh. 1967. Epidemiologic study of Cryptococcus neoformans. Ann. Intern. Med. 67: 727– 732.
144. Newton, J. A.,, S. A. Tasker,, W. D. Bone,, E. C. Oldfield III,, P. E. Olson,, and M. T. Nguyen. 1995. Weekly fluconazole for the suppression of recurrent thrush in HTV-se-ropositive patients: impact on the incidence of disseminated cryptoccal infection. AIDS 9: 1286– 1287.
145. Nightingale, S. D.,, S. X. Cal,, D. M. Peterson,, S. D. Loss,, B. A. Gamble,, D. A. Watson,, C. P. Manzone,, J. E. Baker,, and J. D. Jockusch. 1992. Primary prophylaxis with fluconazole against systemic fungal infections in HIV-positive patients. AIDS 6: 191– 194.
146. Nishikawa, M. M.,, O. D. Sanf anna,, M. S. Lazera,, and B. Wanke. 1996. Use of D-proline assimilation and CGB medium for screening Brazilian Cryptococcus neoformans isolates. J. Med. Vet. Mycol. 34: 365– 366.
147. Noble, R. C.,, and L. F. Fajardo. 1972. Primary cutaneous cryptococcosis. Am. J. Clin. Pathol. 57: 13– 22.
148. Nottenbart, H. C.,, R. F. McGehee,, and J. P. Utz. 1973. Cryptococcosis complicating sarcoidosis. Am. Rev. Respir. Dis. 107: 1060– 1063.
149. Odom, A.,, M. Del Poeta,, J. Perfect,, and J. Heitman. 1997. The immunosuppressant FK506 and its nonimmunosuppressive analog L-685,818 are toxic to Cryptococcus neoformans by inhibition of a common target protein. Antimicrob. Agents Chemother. 41: 156– 161.
150. Olson, P. E.,, K. C. Earhart,, R. J. Rossetti,, J. A. Newton,, and M. R. Wallace. 1997. Smoking and risk of cryptococcosis in patients with AIDS. JAMA 277: 629.
151. Ooi, B.,, B. T. M. Chen,, C. H. Lim,, O. T. Khoo,, and K. T. Chan. 1971. Survival of a patient transplanted with a kidney infected with Cryptococcus neoformans. Transplantation 11: 428– 429.
152. Ostrowski, M.,, I. E. Salit,, W. L. Gold,, D. Sutton,, M. L. Montpetit,, D. Lepine,, and T. Salas. 1993. Idiopathic CD4+ T-lymphocytopenia in two patients. Can. Med. Assoc. J. 149: 1679– 1683.
153. Paya, C. V. 1993. Fungal infections in solid-organ transplantation. Clin. Infect. Dis. 16: 677– 688.
154. Perfect, J. R. 1993. Antifungal prophylaxis: to prevent or not. Am. J. Med. 94: 233– 234.
155. Perfect, J. R.,, and D. T. Durack. 1985. Effects of cyclosporine in experimental cryptococcal meningitis. Infect. Immun. 50: 22– 26.
156. Perfect, J. R.,, N. Ketabchi,, G. M. Cox,, C. W. Ingram,, and C. L. Beiser. 1993. Karyotyping of Cryptococcus neoformans as an epidemiological tool. J. Clin. Microbiol. 31: 3305– 3309.
157. Perfect, J. R.,, B. B. Magee,, and P. T. Magee. 1989. Separation of chromosomes of Cryptococcus neoformans by pulsed field gel electrophoresis. Infect. Immun. 57: 2624– 2627.
158. Perriens, J. H.,, M. Mussa,, M. K. Luabeya,, K. Kayembe,, B. Kapita,, C. Brown,, P. Piot,, and R. Janssen. 1992. Neurological complications of HIV-l-seropositive internal medicine in patients in Kinshasa, Zaire. J. Acquired Immune Defic. Syndr. 5: 333– 340.
159. Piot, P.,, T. C. Quinn,, H. Telman,, F. M. Feinsod,, K. B. Minlangu,, O. Wobin,, N. Mbendi,, P. Mazebo,, K. Ndandi,, W. Stevens,, K. Kalambayi,, S. Mitchell,, C. Bridts,, and J. B. McCormick. 1984. Acquired immunodeficiency syndrome in a heterosexual population in Zaire. Lancet ii: 65– 68.
160. Polacheck, I.,, and G. Lebens. 1989. Electrophoretic karyotype of the pathogenic yeast Cryptococcus neoformans. J. Gen. Microbiol. 135: 65– 71.
161. Polacheck, I.,, G. Lebens,, and J. B. Hicks. 1992. Development of DNA probes for early diagnosis and epidemiological study of cryptococcosis in AIDS patients. J. Clin. Microbiol. 30: 925– 930.
162. Powell, K. E.,, B. A. Dahl,, R. J. Weeks,, and F. E. Tosh. 1972. Airborne Cryptococcus neoformans: particles from pigeon excreta compatible with alveolar deposition. J. Infect. Dis. 125: 412– 415.
163. Rebers, P. A.,, S. A. Barker,, M. Heidelberger,, Z. Dische,, and E. E. Evans. 1958. Precipitation of the specific polysaccharide of Cryptococcus neoformans A by types II and XIV antipneumococcal antisera. J. Am. Chem. Soc. 80: 1135– 1137.
164. Restrepo, A.,, M. E. Salazar,, L. E. Cano,, E. P. Stover,, D. Feldman,, and D. A. Stevens. 1984. Estrogens inhibit mycelium-to-yeast transformation in the fungus Paracoccidioides brasiliensis: implications for resistance of females to paracoccidioidomycosis. Infect. Immun. 46: 346– 353.
165. Rinaldi, M. G.,, D. J. Drutz,, A. Howell,, M. A. Sande,, C. B. Wofsy,, and W. K. Hadley. 1986. Serotypes of Cryptococcus neoformans in patients with AIDS. J. Infect. Dis. 153: 642.
166. Rippon, J. W. 1988. Medical Mycology. The Pathogenic Fungi and the Pathogenic Acti-nomycetes, p. 582. W.B. Saunders, Philadelphia.
167. Rogers, M. E.,, P. Thomas,, E. T. Starcher,, M. C. Noa,, T. J. Bush,, and H. W. Jaffe. 1987. Acquired immunodeficiency syndrome in children: report of the Centers for Disease Control national surveillance, 1982 to 1985. Pediatrics 79: 1008– 1014.
168. Rozenbaum, R.,, and A. J. Goncalves. 1994. Clinical epidemiological study of 171 cases of cryptococcosis. Clin. Infect. Dis. 18: 369– 380.
169. Rozenbaum, R.,, A. J. Goncalves,, B. Wanke,, and W. Viera. 1990. Cryptococcus neoformans var. gattii in a Brazilian AIDS patient. Mycopathologia 112: 33– 34.
170. Rozenbaum, R.,, A. J. Goncalves,, B. Wanke,, M. J. Caiuby,, H. Clemente,, M. D. S. Lazera,, P. C. F. Monteiro,, and A. T. Londero. 1992. Cryptococcus neoformans varieties as agents of cryptococcosis in Brazil. Mycopathologia 119: 133– 136.
171. Ruane, R. J.,, L. J. Walker,, and W. L. George. 1988. Disseminated infection caused by urease-negative Cryptococcus neoformans. J. Clin. Microbiol. 26: 2224– 2225.
172. Ruiz, A.,, and G. S. Bulmer. 1981. Particle size of airborne Cryptococcus neoformans in a tower. Appl. Environ. Microbiol. 41: 1225– 1229.
173. Ruiz, A.,, D. Velez,, and R. A. Fromtling. 1989. Isolation of saprophytic Cryptococcus neoformans from Puerto Rico: distribution and variety. Mycopathologia 106: 167– 170.
174. Salkowski, C. A.,, K. F. Bartizal,, M. Balish,, and E. Balish. 1987. Colonization and pathogenesis of Cryptococcus neoformans in gnotobiotic mice. Infect. Immun. 55: 2000– 2005.
175. Salvin, S. B. 1959. Current concepts of diagnostic serology and skin hypersensitivity in the mycoses. Am. J. Med. 27: 97– 114.
176. Salyer, W. R.,, D. C. Salyer,, and R. D. Baker. 1974. Primary complex of Cryptococcus and pulmonary lymph nodes, J. Infect. Dis. 130: 74– 77.
177. Sarosi, G. A.,, J. D. Parker,, I. L. Doto,, and F. E. Tosh. 1992. Amphotericin B in cryptococcal meningitis. Ann. Intern. Med. 71: 1079– 1087.
178. Sarosi, G. A.,, P. M. Silberfarb,, and F. E. Tosh. 1971. Cutaneous cryptococcosis: a sentinel of disseminated disease. Arch. Dermatol. 104: 1– 3.
179. Schimpff, S. C.,, and J. E. Bennett. 1975. Abnormalities in cell-mediated immunity in patients with Cryptococcus neoformans infection. J. Allergy Clin. Immunol. 55: 430– 441.
180. Sekhon, A. S.,, S. N. Banneijee,, B. M. Mielke,, H. Idikio,, G. Wood,, and J. M. S. Dixon. 1990. Current status of cryptococcosis in Canada. Mycoses 33: 73– 80.
181. Shaariah, W.,, Z. Morad,, and A. B. Suleiman. 1992. Cryptococcosis in renal transplant recipients. Transplant. Proc. 24: 1898– 1899.
182. Shimazu, W.,, M. Ando,, T. Sakata,, C. Yoshida,, and S. Araki. 1984. Hypersensitivity pneumonitis induced by Trichosporon cutaneum. Am. Rev. Respir. Dis. 130: 407– 411.
183. Shimizu, R. Y.,, D. H. Howard,, and M. N. Clancy. 1986. The variety of Cryptococcus neoformans in patients with AIDS. J. Infect. Dis. 154: 1042.
184. Siewers, C. M. E.,, and H. G. Cramblett. 1964. Cryptococcosis (torulosis) in children. A report of four cases. Pediatrics 34: 393– 400.
185. Singh, N. 1997. Clinical and environmental factors associated with cryptococcosis in liver transplant patients. Clin. Infect. Dis. 24: 744– 745.
186. Smith, D. K.,, J. J. Neal,, and S. D. Holmberg. 1993. Unexplained opportunistic infections and CD4+ T-lymphocytopenia without HIV infection. N. Engl. J. Med. 328: 373– 379.
187. Smith, J. H.,, M. M. Nichols,, A. Goldman,, F. C. Schmalstieg,, and R. M. Goldblum. 1982. Disseminated cryptococcosis in an infant with severe combined immunodeficiency. Hum. Pathol. 13: 500– 503.
188. Smith, J. W.,, and W. C. Arnold. 1988. Cryptococcal peritonitis in patients with peritoneal dialysis. Am. J. Kidney Dis. 11: 430– 433.
189. Sokolowski, J. W.,, R. F. Schillaci,, and T. E. Motley. 1969. Disseminated cryptococcosis complicating sarcoidosis. Am. Rev. Respir. Dis. 100: 717– 722.
190. Sorrell, T. C.,, S. C. Chen,, P. Ruma,, W. Meyer,, T. J. Pfeiffer,, D. H. Ellis,, and A. G. Brownlee. 1996. Concordance of clinical and environmental isolates of Cryptococcus neoformans var. gattii by random amplification of polymorphic DNA analysis and PCR fingerprinting. J. Clin. Microbiol. 34: 1253– 1260.
191. Sorvillo, E.,, G. Beall,, P. A. Turner,, V. L. Beer,, A. A. Kovacs,, and P. R. Kemdt. 1997. Incidence and factors associated with extrapulmonary cryptococcosis among persons with HIV infection in Los Angeles County. AIDS 11: 673– 679.
192. Speed, B.,, and D. Dunt. 1995. Clinical and host differences between infections with the two varieties of Cryptococcus neoformans. Clin. Infect. Dis. 21: 28– 34.
193. Speed, B. R.,, and J. Kaldor. 1997. Rarity of cryptococcal infection in children. Pediatr. Infect. Dis. J. 16: 536– 537.
194. Speed, B. R.,, L. Strawbridge,, and D. H. Ellis. 1993. Cryptococcus neoformans var. gattii meningitis in an Australian patient with AIDS. J. Med. Vet. Mycol. 31: 395– 399.
195. Spickard, A.,, W. T. Butler,, V. Andriole,, and J. P. Utz. 1963. The improved prognosis of cryptococcal meningitis with amphotericin B therapy. Ann. Intern. Med. 58: 66– 83.
196. Spira, T. J.,, B. M. Jones,, J. K. A. Nicholson,, R. B. Lala,, T. Rowe,, A. C. Mawle,, C. B. Lauter,, J. A. Shulman,, and R. A. Monson. 1993. Idiopathic CD4+ T-lymphocy-topenia—an analysis of five patients with unexplained opportunistic infections. N. Engl. J. Med. 328: 386– 392.
197. Spitzer, E. D.,, and S. G. Spitzer. 1992. Use of a dispersed repetitive DNA element to distinguish clinical isolates of Cryptococcus neoformans. J. Clin. Microbiol. 30: 1094– 1097.
198. Spitzer, E. D.,, S. G. Spitzer,, L. F. Freundlich,, and A. Casadevall. 1993. Persistence of the initial infection in recurrent cryptococcal meningitis. Lancet 341: 595– 596.
199. Stamm, A. M.,, R. B. Diasio,, W. E. Dismukes,, S. Shadomy,, G. A. Cloud,, C. A. Bowles,, and G. H. Karam. 1987. Toxicity of Amphotericin B plus flucytosine in 194 patients with cryptococcal meningitis. Am. J. Med. 83: 236– 242.
200. St.-Germain, G.,, G. Noel,, and K. J. Kwon-Chung. 1988. Disseminated cryptococcosis due to Cryptococcus neoformans variety gattii in a Canadian patient with AIDS. Eur. J. Clin. Microbiol. Infect. Dis. 7: 587– 588.
201. Stone, B. D.,, and J. G. Wheeler. 1990. Disseminated cryptococcal infection in a patient with hyperimmunoglobulmemia E syndrome. J. Pediatr. 117: 92– 95.
202. Sullivan, D.,, K. Haynes,, G. Moran,, D. Shanley,, and D. Coleman. 1996. Persistence, replacement, and microevolution of Cryptococcus neoformans strains in recurrent meningitis in AIDS patients. J. Clin. Microbiol. 34: 1739– 1744.
203. Summerbell, R. C.,, F. Staib,, R. Dales,, N. Nolard,, J. Kane,, H. Zwanenburg,, R. Burnett,, S. Kradjen,, D. Fung,, and D. Leong. 1992. Ecology of fungi in human dwellings. J. Med. Vet. Mycol. 30( Suppl. l): 279– 285.
204. Sussman, E. J.,, F. MacMahon,, D. Wright,, and H. M. Friedman. 1984. Cutaneous cryptococcosis without evidence of systemic involvement, J. Am. Acad. Dermatol. 11: 371– 374.
205. Swinne, D.,, M. Deppner,, S. Maniratunga,, R. Laroche,, J.-J. Floch,, and P. Kadende. 1991. AIDS-associated cryptococcosis in Bujumbura, Burundi: an epidimiological study. J. Med. Vet. Mycol. 29: 25– 30.
206. Swinne, D.,, K. Kayembe,, and M. Niyimi. 1986. Isolation of saprophytic Cryptococcus neoformans var. neoformans in Kinshasa, Zaire. Ann. Soc. Belg. Med. Trop. 66: 57– 61.
207. Swinne, D.,, J. B. Nkurikiyinfura,, and T. L. Muyembe. 1986. Clinical isolates of Cryptococcus neoformans from Zaire. Eur. J. Clin. Microbiol. 5: 50– 51.
208. Tabone, M.-C.,, G. Leverger,, J. Landman,, C. Aznar,, L. Boccon-Gibod,, and G. Lasfar-gues. 1994. Disseminated lymphonodular cryptococcosis in a child with X-linked hyper-IgM immunodeficiency. Pediatr. Infect. Dis. J. 13: 77– 79.
209. Taelman, H.,, J. Clerinx,, A. Kagame,, J. Batungwanayo,, A. Nyirabareja,, and J. Bogaerts. 1991. Cryptococcosis, another growing burden in central Africa. Lancet 338: 761.
210. Takos, M. J. 1956. Experimental cryptococcosis produced by the ingestion of virulent organisms. N. Engl. J. Med. 254: 598– 601.
211. Tanphaichitra, D.,, S. Sahaphongs,, and S. Srimuang. 1988. Cryptococcal antigen survey among racing pigeon workers and patients with cryptococcosis, pythiosis, histoplasmosis, and penicilliosis. Int. J. Clin. Pharm. Res. 8: 433– 439.
212. Ting, S. E.,, B. E. Glader,, and C. G. Prober. 1991. Cryptococcus infection in a nine-year-old child with hemophilia and the acquired immunodeficiency syndrome. Pediatr. Infect. Dis. J. 10: 76– 77.
214. Van de Perre, P.,, P. Lepage,, P. Kestelyn,, A. Hekker,, D. Rouvroy,, J. Bogaerts,, J. Kayihigi,, and J.-P. Butzler. 1984. Acquired immunodeficiency syndrome in Rwanda. Lancet ii: 62– 65.
215. Varma, A.,, and K. J. Kwon-Chung. 1989. Restriction fragment polymorphism in mitochondrial DNA of Cryptococcus neoformans. J. Gen. Microbiol. 135: 3353– 3362.
216. Varma, A.,, and K. J. Kwon-Chung. 1992. DNA probe for typing of Cryptococcus neoformans. J. Clin. Microbiol. 30: 2960– 2967.
217. Varma, A.,, D. Swinne,, F. Staib,, J. E. Bennett,, and K. J. Kwon-Chung. 1995. Diversity of DNA fingerprints in Cryptococcus neoformans. J. Clin. Microbiol. 33: 1807– 1814.
218. Villanueva, E.,, M. Mendoza,, E. Torres,, M. B. Albornoz,, M. E. Cavazza,, and G. Urbina. 1989. Serotipificacion de 27 cepas de Cryptococcus neoformans aisladas en Venezuela. Acta Científica Venezolana 40: 151– 154.
219. Wang, E.,, Y. So,, E. Vittinghoff,, H. Malani,, A. Reingold,, E. Lewis,, J. Giordano,, and R. Janssen. 1995. Incidence proportion of and risk factors for AIDS patients diagnosed with HIV dementia, central nervous system toxoplasmosis, and cryptococcal meningitis. ƒ. Acquired Immune Defic. Syndr. 8: 75– 82.
220. White, M.,, C. Cirrincione,, A. Blevins,, and D. Armstrong. 1992. Cryptococcal meningitis: outcome in patients with AIDS and patients with neoplastic disease. J. Infect. Dis. 165: 960– 963.
221. Wickes, B. L.,, D. E. Moore,, and K. J. Kwon-Chung. 1994. Comparison of the electro-phoretic karyotypes and chromosomal location of ten genes in the two varieties of Cryptococcus neoformans. Microbiology 140: 543– 555.
222. Yamamoto, Y.,, S. Kohno,, H. Koga,, H. Kakeya,, K. Tomono,, M. Kaku,, T. Yamazaki,, M. Arisawa,, and K. Hara. 1995. Random amplified polymorphic DNA analysis of clinically and environmentally isolated Cryptococcus neoformans in Nagasaki, J. Clin. Microbiol. 33: 3328– 3332.
223. Yinnon, A. M.,, A. Solages,, and J. J. Treanor. 1993. Cryptococcal peritonitis: report of a case developing during continuous peritoneal dialysis and review of the literature. Clin. Infect. Dis. 17: 736– 741.
224. Zimmerman, L. E.,, and H. Rappaport 1954. Occurrence of cryptococcosis in patients with malignant disease of reticuloendothelial system. Am. J. Clin. Pathol. 24: 1050– 1072.
225. Zimmermann, B., III,, M. Spiegel,, and E. V. Lally. 1992. Cryptococcal meningitis in systemic lupus erythematosus. Semin. Arthritis Rheum. 22: 18– 24.
226. Zuger, A.,, E. Louie,, R. S. Holzman,, M. S. Simberkoff,, and J. J. Rahal. 1986. Cryptococcal disease in patients with the acquired immunodeficiency syndrome: diagnostic features and outcome of treatment. Ann. Intern. Med. 104: 234– 240.

Tables

Epidemiology
Citation: Casadevall A, Perfect J. 1998. Epidemiology, p 351-380. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch11
/content/10.1128/9781555818241.chap11.tab11-1
Table 1

Prevalence of cryptococcal infection in HIV-infected patients in the United States

Yеаr the study was published. All studies were retrospective.

Prevalence of infection is the number of cases of cryptococcosis divided by the number of HIV-infected patients.

The authors of this study suggested that the drier climate of southern California may contribute to a lower prevalence of infection relative to other regions of the United States.

10.1128/9781555818241/tab11-1_thmb.gif
10.1128/9781555818241/tab11-1.gif
Generic image for table
Table 1

Prevalence of cryptococcal infection in HIV-infected patients in the United States

Yеаr the study was published. All studies were retrospective.

Prevalence of infection is the number of cases of cryptococcosis divided by the number of HIV-infected patients.

The authors of this study suggested that the drier climate of southern California may contribute to a lower prevalence of infection relative to other regions of the United States.

Citation: Casadevall A, Perfect J. 1998. Epidemiology, p 351-380. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch11
/content/10.1128/9781555818241.chap11.tab11-2
Table 2

Prevalence of cryptococcal infection in HIV-infected patients in several countries

10.1128/9781555818241/tab11-2_thmb.gif
10.1128/9781555818241/tab11-2.gif
Generic image for table
Table 2

Prevalence of cryptococcal infection in HIV-infected patients in several countries

Citation: Casadevall A, Perfect J. 1998. Epidemiology, p 351-380. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch11
/content/10.1128/9781555818241.chap11.tab11-3
Table 3

Predominance of male patients in studies of clinical cryptococcosis

Many of the patients in this study had lymphoproliferative neoplasms.

This study reviewed several previous studies, and the total number of patients reported is shown here.

All or most of the patients in these studies had been infected with the HIV virus.

10.1128/9781555818241/tab11-3_thmb.gif
10.1128/9781555818241/tab11-3.gif
Generic image for table
Table 3

Predominance of male patients in studies of clinical cryptococcosis

Many of the patients in this study had lymphoproliferative neoplasms.

This study reviewed several previous studies, and the total number of patients reported is shown here.

All or most of the patients in these studies had been infected with the HIV virus.

Citation: Casadevall A, Perfect J. 1998. Epidemiology, p 351-380. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch11
/content/10.1128/9781555818241.chap11.tab11-4
Table 4

Conditions associated with predisposition to infections

Diabetes mellitus has historically been considered a risk factor for cryptococcal infection. However, diabetes is a common disease, and it is unclear whether this condition is truly a risk factor for cryptococcosis.

10.1128/9781555818241/tab11-4_thmb.gif
10.1128/9781555818241/tab11-4.gif
Generic image for table
Table 4

Conditions associated with predisposition to infections

Diabetes mellitus has historically been considered a risk factor for cryptococcal infection. However, diabetes is a common disease, and it is unclear whether this condition is truly a risk factor for cryptococcosis.

Citation: Casadevall A, Perfect J. 1998. Epidemiology, p 351-380. In . ASM Press, Washington, DC. doi: 10.1128/9781555818241.ch11

Back to top
This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error