Abstract
Cryptococcus is an infective fungal disease presenting in immunocompromised individuals, especially those with human immunodeficiency virus (HIV) infection. While the most common manifestation of the disease is papilledema due to involvement of the central nervous system, it can occasionally result in intraocular spread causing vitritis and endophthalmitis. One-third to one-half of patients with cryptococcal meningitis exhibit neuro-ophthalmic manifestations and vision loss is common. As the ophthalmologist might be the first physician to see these patients, he/she should be familiar with this entity. Prompt diagnosis and referral for effective therapy is mandatory. Despite progress in the rolling out antiretroviral therapy, cryptococcal meningitis is still a leading killer of AIDS patients worldwide. In the index chapter, ocular manifestations of Cryptococcus infection have been highlighted.
This is a preview of subscription content, log in via an institution.
Suggested Reading
Abassi M, Boulware DR, Rhein J. Cryptococcal meningitis: diagnosis and management update. Curr Trop Med Rep. 2015;2:90–9.
Avendaño J, Tanishima T, Kuwabara T. Ocular cryptococcosis. Am J Ophthalmol. 1978;86:110–3.
Baillif S, Delas J, Asrargis A, Gastaud P. Multimodal imaging of cryptococcal choroiditis – photo essay. Retina. 2013;33:249–51.
Beardsley J, Wolbers M, Kibengo FM, The CryptoDex Investigators, et al. Adjunctive dexamethasone in HIV-associated cryptococcal meningitis. N Engl J Med. 2016;374:542–54.
Boulware DR, Meya DB, Muzoora C, The COAT Trial Team, et al. Timing of antiretroviral therapy after diagnosis of cryptococcal meningitis. N Engl J Med. 2014;370:2487–98.
Carney MD, Combs JL, Waschler W. Cryptococcal choroiditis. Retina. 1990;10:27–32.
Charles NC, Boxrud CA, Small EA. Cryptococcosis of the anterior segment in AIDS. Ophthalmology. 1992;99:813–6.
Chau TTH, Mai NH, Phu NH, et al. A prospective descsriptive study of cryptococcal meningitis in HIV uninfected patient in Vietnam – high prevalence of Cryptococcus neoformans var grubii in the absence of underlying diseae. BMC Infect Dis. 2010;10:199.
Coccia L, Calista D, Boschini A. Eyelid nodule: a sentinel lesion of disseminated cryptococcosis in a patient with AIDS. Arch Ophthalmol. 1999;117:271–2.
Ehrhorn J, Groose G, Staib F, Wollensak J. Intraocular cryptococcosis. Klin Monatsbl Augenheilkd. 1976;168:577–83. [in German].
Fine HF, Chang MA, Dunn Jr JP. Bilateral cryptococcal choroidtis. Arch Ophthalmol. 2004;122:1726–7.
François J, Elewaut-Rysselaere M, De Vos E. Les mycoses oculaires. Paris: Masson & Cie; 1968. p. 266–74.
Gandhi SA, McMeecking AA, Friedberg D, Holzman RS. Cryptococcal choroiditis in a patient with AIDS: case report and review. Clin Infect Dis. 1996;23:1193–4.
Hiles DA, Font RL. Bilateral intraocular cryptococcosis with unilateral spontaneous regression. Am J Ophthalmol. 1968;65:98–108.
Kaplan J, Vallabhaneni S, Smith R, et al. Cryptococcal antigen screening and early antifungal treatment to prevent cryptococcal meningitis: a review of the literature. J Acquir Immune Defic Syndr. 2015;68:S331–9.
Kestelyn P, Taelman H, Bogaerts J, et al. Ophthalmic manifestations of infections with Cryptococcus neoformans in patients with the acquired immune deficiency syndrome. Am J Ophthalmol. 1993;116:721–7.
Khurana RN, Javaheri M, Rao N. Ophthalmic manifestations of immune reconstitution inflammatory syndrome associated with Cryptococcus neoformans. Ocul Immunol Inflamm. 2008;16:185–90.
Kresch ZA, Espinosa-Heidmann D, Harper T, Jamie-Miller G. Disseminated Cryptococcus with ocular cryptococcoma in a HIV-negative patient. Int Ophthalmol. 2012;32:281–4.
Loyse A, Moodley A, Rich P, et al. Neurological, visual, and MRI brain scan findings in 87 South African patients with HIV-associated cryptococcal meningoencephalitis. J Infect. 2015;70:668–75.
Mao F, Sun H, Li D. Ophthalmic manifestation in AIDS patients with cryptococcal meningitis. Zhonghua Yan Ke Za Zhi. 2015;51:364–8. [Article in Chinese].
Maziarz EK, Perfect JR. Cryptococcosis. Infect Dis Clin N Am. 2016;30:179–206.
Meya DB, Manabe YC, Boulware DR, Janoff EN. The immunopathogenesis of cryptococcal immune reconstitution inflammatory syndrome: understanding a conundrum. Curr Opin Infect Dis. 2016;29:10–22.
Morinelli EN, Dugel PU, Riffenberg R, Rao NA. Infectious multifocal choroiditis in patients with AIDS. Ophthalmology. 1993;100:1014–24.
Muccioli C, Belfort Jr R, Neves R, Rao N. Limbal and choroidal Cryptococcus infection in the acquired immunodeficiency syndrome. Am J Ophthalmol. 1995;120:539–40.
Pappas PG. An expanded role for therapeutic lumbar punctures in newly diagnosed AIDS-associated cryptococcal meningitis? Clin Infect Dis. 2014;59:1615–7.
Perfect JR, Dismukes WE, Dromer F, et al. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the Infectious Disease Society of America. Clin Infect Dis. 2010;50:291–322.
Pettit TH, Edwards JE, Purdy EP, Bullock JD. Endogenous fungal endophthalmitis. In: Pepose JS, Holland GN, Wilhelmus KR, editors. Ocular infection & immunity. St. Louis: Mosby; 1996. p. 1262–86.
Rex JH, Larsen RA, Dismukes WE, Cloud GA, Bennet JE. Catastrophic visual loss due to Cryptococcus neoformans meningitis. Medicine. 1993;72:209–24.
Seaton RA, Verma N, Naraqi S, Wembri JP, Warrell DA. Visual loss in immunocompetent patients with Cryptococcus neoformans var. Trans R Soc Trop Med Hyg. 1997;91:44–9.
Sheu SJ, ChenYC KNW, Waang JH, Chen CJ. Endogenous cryptococcal endophthalmitis. Ophthalmology. 1998;105:377–81.
Shields JA, Wright DM, Augsburger JJ, Wolkowicz MI. Cryptococcal chorioretinitis. Am J Ophthalmol. 1980;89:210–7.
Shulman J, de la Cruz EL, Latkany P, Milman T, Iacob C, Sanjana V. Cryptococcal chorioretinitis with immune reconstitution inflammatory syndrome. Ocul Immunol Inflamm. 2009;17(5):314.
Tenforde MW, Wake R, Leeme T, Jarvis JN. HIV-associated cryptococcal meningitis: bridging the gap between developed and resource-limited settings. Curr Clin Microbiol Rep. 2016;3:92–102.
Waddell KM, Lucas SB, Downing RG. Case reports and small case series: conjunctival cryptococcosis in the acquired immunodeficiency syndrome. Arch Ophthalmol. 2000;118:1452–3.
Weinstein JM. Fungi and mycotic disease. In: Miller NR, Newman NJ, editors. Walsh and Hoyt’s clinical neuro-ophthalmology. 6th ed. Philadelphia: Lippicott, Williams & Wilkins; 2005. p. 2817–52.
World Health Organization. Rapid advice: diagnosis, prevention and management of cryptococcal disease in HIV-infected adults, adolescents and children. Geneva: World Health Organization; 2011.
Wykoff C, Albini TA, Couvillion SS, Dubovy SR, Davis JL. Intraocular cryptococcoma. Arch Ophthalmol. 2009;127:700–2.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer (India) Pvt. Ltd.
About this entry
Cite this entry
Kestelyn, P. (2018). Cryptococcus. In: Gupta, V., Nguyen, Q., LeHoang, P., Herbort Jr., C. (eds) The Uveitis Atlas. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2506-5_41-1
Download citation
DOI: https://doi.org/10.1007/978-81-322-2506-5_41-1
Received:
Accepted:
Published:
Publisher Name: Springer, New Delhi
Print ISBN: 978-81-322-2506-5
Online ISBN: 978-81-322-2506-5
eBook Packages: Springer Reference MedicineReference Module Medicine