Cryptococcosis, also known as cryptococcal disease is a potentially fatal fungal disease. It is caused by inhalation of an encapsulated yeast called Cryptococcus neoformans. Cryptococcosis is believed to be acquired by inhalation of the infectious propagule from the environment. Although the exact nature of the infectious propagule is unknown, the leading hypothesis is the basidiospore created through sexual or asexual reproduction.
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There are three identified Cryptococcus strains that causes disease worldwide namely Cryptococcus neoformans, Cryptococcus grubii and Cryptococcus gattii. Exposure via respiratory or the gastrointestinal tract are considered as the most common and opportunistic pathway for the organism entry in the host. Cryptococcus neoformans can be found worldwide in soil, birds, animals and humans. Whereas, alternative route of administration can be through transplant of infected tissue, surgical instrument or laboratory instruments. Cryptococcosis neoformans can affect a person’s lungs causing pneumonia, or central nervous system causing meningitis.
People with impaired immunity, such as cancer or AIDS patients that acquire the cryptococcosis illness are predominantly infected with the C. neoformans and C. grubii, while C. gattii can cause illness in not only immunocompromised individuals but also among healthy individuals. In between 1999 and 2010, 281 cases of C. gattii have been reported to the British Columbia Centre for Disease Control among animals and human residing in Vancouver Island and surrounding areas within Canada and the northwest United States.
With the availability highly active antiretroviral therapy (HAART), the management of cryptococcosis has become a combination of established antifungal treatments together with treatment of any other associated disease. Although the prevalent use of HAART has lowered the incidences of cryptococcosis in medically developed countries yet the incidences and mortality due to infection is still high in regions having limited access to healthcare, HAART and uncontrolled HIV disease. AIDS associated Cryptococcosis accounts for 50 percent of all Cryptococcal infections reported annually and usually occurs in HIV patients when their CD4 lymphocyte count is below 200/mm3.
Market for Cryptococcosis can be segmented on the basis of anatomical location that is central nervous system, Cryptococcosis of bone and so on and risk groups which included HIV infected and organ transplant individual.
In 2000, the Infectious Diseases Society of America (IDSA) first published Practice Guidelines for the Management of Cryptococcal Disease based on clinical data evidences and expert opinion to manage and curb down the highly recognizable invasive fungal pathogen. However, over the past decade a series of new clinical issues and host risk groups have arisen which demands for revision of guideline to proper and efficient management of cryptococcosis.
The major symptoms of cryptococcosis include fever, malaise, excessive coughing mental status changes and vision defects. Till date there are no novel drug or vaccines available specifically to treat cryptococcosis.
Human disease is endemic in Australia, parts of Africa, the Mediterranean region, Papua New Guinea, India, Southern California, Mexico, Brazil, Paraguay and south-east Asia. Some of the organization/ research centers working on the development of vaccine/drug include Pfizer Inc., Janssen Pharmaceutical, Inc., Johnson & Johnson, MedStar Health Research Institute among others.
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Last updated on: 29/09/2016
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