Cryptococcosis in the era of AIDS--100 years after the discovery of Cryptococcus neoformans

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Clinical Microbiology Reviews, Oct 1995, 515-548, Vol 8, No. 4
Copyright © 1995 by the American Society for Microbiology. All rights reserved.

Cryptococcosis in the era of AIDS--100 years after the discovery of Cryptococcus neoformans

TG Mitchell and JR Perfect
Department of Microbiology, Duke University Medical Center, Durham, North Carolina 27710, USA.

Although Cryptococcus neoformans and cryptococcosis have existed for several millennia, a century has passed since the discovery of this encapsulated yeast and its devastating disease. With the advent of the AIDS pandemic, cryptococcal meningitis has emerged as a leading cause of infectious morbidity and mortality and a frequently life-threatening opportunistic mycosis among patients with AIDS. Both basic and clinical research have accelerated in the 1990s, and this review attempts to highlight some of these advances. The discussion covers recent findings, current concepts, controversies, and unresolved issues related to the ecology and genetics of C. neoformans; the surface structure of the yeast; and the mechanisms of host defense. Regarding cell-mediated immunity, CD4+ T cells are crucial for successful resistance, but CD8+ T cells may also participate significantly in the cytokine-mediated activation of anticryptococcal effector cells. In addition to cell-mediated immunity, monoclonal antibodies to the major capsular polysaccharide, the glucuronoxylomannan, offer some protection in murine models of cryptococcosis. Clinical concepts are presented that relate to the distinctive features of cryptococcosis in patients with AIDS and the diagnosis, treatment, and prevention of cryptococcosis in AIDS patients.

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Calvo, B. M., Colombo, A. L., Fischman, O., Santiago, A., Thompson, L., Lazera, M., Telles, F., Fukushima, K., Nishimura, K., Tanaka, R., Myiajy, M., Moretti-Branchini, M. L. (2001). Antifungal Susceptibilities, Varieties, and Electrophoretic Karyotypes of Clinical Isolates of Cryptococcus neoformans from Brazil, Chile, and Venezuela. J. Clin. Microbiol. 39: 2348-2350 [Abstract] [Full Text]
Barchiesi, F., Schimizzi, A. M., Najvar, L. K., Bocanegra, R., Caselli, F., Di Cesare, S., Giannini, D., Di Francesco, L. F., Giacometti, A., Carle, F., Scalise, G., Graybill, J. R. (2001). Interactions of Posaconazole and Flucytosine against Cryptococcus neoformans. Antimicrob. Agents Chemother. 45: 1355-1359 [Abstract] [Full Text]
Rosas, A. L., Nosanchuk, J. D., Casadevall, A. (2001). Passive Immunization with Melanin-Binding Monoclonal Antibodies Prolongs Survival of Mice with Lethal Cryptococcus neoformans Infection. Infect. Immun. 69: 3410-3412 [Abstract] [Full Text]
D'Souza, C. A., Alspaugh, J. A., Yue, C., Harashima, T., Cox, G. M., Perfect, J. R., Heitman, J. (2001). Cyclic AMP-Dependent Protein Kinase Controls Virulence of the Fungal Pathogen Cryptococcus neoformans. Mol. Cell. Biol. 21: 3179-3191 [Abstract] [Full Text]
Manavathu, E. K., Dimmock, J. R., Vashishtha, S. C., Chandrasekar, P. H. (2001). Inhibition of H+-ATPase-mediated proton pumping in Cryptococcus neoformans by a novel conjugated styryl ketone. J Antimicrob Chemother 47: 491-494 [Abstract] [Full Text]
Thorson, L. M., Doxsee, D., Scott, M. G., Wheeler, P., Stokes, R. W. (2001). Effect of Mycobacterial Phospholipids on Interaction of Mycobacterium tuberculosis with Macrophages. Infect. Immun. 69: 2172-2179 [Abstract] [Full Text]
Garcia-Hermoso, D., Dromer, F., Mathoulin-Pelissier, S., Janbon, G. (2001). Are Two Cryptococcus neoformans Strains Epidemiologically Linked?. J. Clin. Microbiol. 39: 1402-1406 [Abstract] [Full Text]
Boekhout, T., Theelen, B., Diaz, M., Fell, J. W., Hop, W. C. J., Abeln, E. C. A., Dromer, F., Meyer, W. (2001). Hybrid genotypes in the pathogenic yeast Cryptococcus neoformans. Microbiology 147: 891-907 [Abstract] [Full Text]

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