How to diagnose cryptococcal infection?

After cryptococcus infects the body, it is relatively rare for disease to occur. For cryptococcal infection, patients may experience headaches, which may gradually worsen. In more severe cases, they may also experience nausea and vomiting. Patients must seek medical attention promptly if they experience any physical discomfort to avoid more serious symptoms, such as eye paralysis.

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Causes of Cryptococcal Infection:

Normal people are often exposed to the environment of Cryptococcus neoformans, but very few people develop the disease. The human body's immunity to Cryptococcus includes cellular immunity and humoral immunity. Macrophages, neutrophils, lymphocytes, and natural killer cells play an important role. Humoral immunity includes: anti-capsular polysaccharide antibodies and complement participate in opsonophagocytosis, assisting macrophages to phagocytize cryptococci. Only when the body's resistance is reduced can pathogens easily invade the human body and cause disease.

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Diagnosis of Cryptococcal Infection

1. Central nervous system cryptococcosis Cryptococcus neoformans is prone to invade the central nervous system for unclear reasons, but it may be related to the presence of asparagine and creatinine in the cerebrospinal fluid, which helps bacterial growth. It can also easily cause subacute or chronic meningitis and meningoencephalitis. In 1978, Forar counted 220 cases of cryptococcal infection, only 19 of which had no central nervous system involvement. Therefore, cryptococcal meningitis is the most common type of pleurisy caused by fungi. Its clinical manifestations are quite similar to tuberculous meningitis, but sometimes cryptococcal granuloma is limited to a certain part of the brain and spinal cord, which is similar to a brain tumor or brain abscess.

The onset is generally slow, with the initial symptoms mostly being mild paroxysmal headaches, which then gradually worsen, but can still be relieved naturally and often recur; they are often accompanied by nausea, vomiting, dizziness and varying degrees of fever. After a few weeks or months, symptoms of increased intracranial pressure may appear, such as neck stiffness, positive meningeal irritation signs and various eye signs (blurred vision, vertigo, diplopia, photophobia, eye paralysis, tremor, amblyopia, etc.). It is often accompanied by fundus edema and retinal exudative changes.

3. Mucocutaneous cryptococcosis Mucocutaneous cryptococcosis rarely occurs alone and is often a local manifestation of systemic cryptococcosis. It may be caused by dissemination from the meninges, lungs, and other lesions. The main manifestations are facial acne-like rash, nodules, or central necrosis and ulcer formation as the lesion expands. Occasionally, it also occurs on the mucous membranes of the hard palate, soft palate, tongue, gums, pharynx, and nasal cavity. The subjective symptoms are not serious and the course of the disease is long.

4. Cryptococcosis of bone often invades the skull and spine, but the joints are often not affected. Bone lesions are chronic, multiple, scattered destructive lesions without periosteal hyperplasia, but may be accompanied by swelling and pain. There were no special findings on X-ray.

5. Visceral cryptococcosis is caused by disseminated infection. The heart, testicles, prostate, eyes, etc. are often affected, but the kidneys, liver, spleen, lymph nodes, etc. are not affected. Infections of the gastrointestinal tract and genitourinary system can mimic tuberculosis. Sometimes it can directly invade the eye through the subarachnoid space or spread through the bloodstream to enter the eye's pigment layer, retina, lens, etc. In some cases, it can invade the heart and cause endocarditis.