44 CNS Infections

Cryptococcus

  • thick capsule evade immune system

  • meningitis

  • Egyptian crypt for cryptococcus
  • coffins: Yeast are round and heavily encapsulated
  • repeating pattern on coffin: Cryptococcus capsule has a repeating polysaccharide capsular antigen. Main virulence factor for antiphagocytes
  • NH3 spray bottle: Urease positive
  • pigeons with droppings. Archaeologists coughing: Cryptococcus is inhaled from soil and/or pigeon droppings. Settles in lungs
  • cane: Immunocompromised (HIV)

  • different from bacterial (abrupt onset)
  • important: raise ICP, risk of herniation

  • archaeologists coughing: Pulmonary Crypto causes cough and dyspnea
  • Neck brace: Can cause cryptococcosis, a fungal meningitis. Most common cause of fungal meningitis
  • sweating: fever
  • frogs, pinecone, with flute: flucytosine/amphoterecin B joint treatment with maintenaince fluconazole

  • soap bubbles on lung: Diagnose with a microscopic exam of bronchopulmonary washing
  • red and silver stripes: Diagnosis of pulmonary Crypto can be aided by mucicarmine or methenamine silver stain
  • vase with bubbling tar: India Ink test can diagnose Crypto meningitis with lumbar puncture/CSF. Background dark, transparent organism
  • latex gloves next to repeating patterns: Latex agglutination test detects polysaccharide capsular antigens and causes their agglutination

  • soap bubbles on head: Causes "soap bubble" lesions in gray matter

PML