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.