Intorduction
As we know, Cryptococcosis is considered as the most common fungal
infection of the brain. It’s also considered as the most common fungal
infection in people positive for HIV (1). Cryptococcosis as an important
opportunistic infection with a high mortality and morbidity rate can be
caused by two encapsulated cryptococcus species: Cryptococcus neoformans
and Cryptococcus gattii. Available data shows that C.gattii is
responsible for the initiation of disease in immunocompetents but
C.neoformans is responsible for invasive disorders in immunocompromised
patients (2). Polysaccharide capsule was described as its virulence
factor that is composed of glucuronoxylomannan (its major component),
galactoxylomannan, and mannoproteins which can activate phagocytosis by
alveolar macrophages following inhalation. Since they can make it
through phagocytosis, these fungal cells spread hematogenously via cell
lysis or vomocytosis (a nonlytic process in which an immune response is
being prevented) (1, 3). After exposure, these fungal cells can cause
asymptomatic condition or they can cause pneumonia-like manifestations.
They can also lead to some neurological clinical conditions such as
meningitis, meningoencephalitis, and cryptococcomas (4). Regardless of
the decreasing rate of cryptococcosis, world still has a high
cryptococcal infection incidence in immunocompromised patients (5). The
most common route to cryptococcosis diagnosis is through testing
biological body fluids for cryptococcal antigen (6).
Here, we report a case with newly diagnosed HIV and concurrent
cryptococcal pneumonia and meningoencephalitis.