Cryptococcus laurentii (Non Cryptococcus neoformans/gatti) infections – Immunocompromised or Immunocompetent -Who is at risk? – Systematic review

Abstract

Non neoformans cryptococci are usually regarded as saprophytes and human infections are rare. C.laurentii is rare of the non neoformans Cryptococci that can cause human infections. Incidence of human infections with Cryptococcus laurentii and albidus has increased over last couple of decades. The risk factors for C. laurentii infections usually include diminished Cell mediated immunity and presence of invasive devices, while mortality risks increases with CNS involvement and age above 45 years. Clinical manifestations are indistinguishable from other invasive yeast infections. High index of suspicion with any yeasts associated with raised inflammatory biomarkers and presence of neutrophils in the specimen’s stained smear is important in the diagnosis and prompt initiation of appropriate treatment since C. laurentii shows low susceptibility to fluconazole. We report here a case of lower respiratory infection due to Cryptococcus laurentii in a 57 years old female patient with bronchiectasis. The patient was admitted with complaints of fever, dyspnoea with productive cough. She was on antibiotic treatment. Her chest x-ray report revealed infiltrative opacities at right upper mid zone of the lungs and pleural effusion at left lower zone. The patient later also developed quadruparesis and urinary incontinence.