Volume 19, Number 10—October 2013
CME ACTIVITY - Research
Cryptococcus gattii Infections in Multiple States Outside the US Pacific Northwest
Julie R. Harris
, Shawn R. Lockhart, Gail Sondermeyer, Duc J. Vugia, Matthew B. Crist, Melissa Tobin D’Angelo, Brenda Sellers, Carlos Franco-Paredes, Monear Makvandi, Chad Smelser, John Greene, Danielle Stanek, Kimberly Signs, Randall J. Nett, Tom Chiller, and Benjamin J. Park
, Shawn R. Lockhart, Gail Sondermeyer, Duc J. Vugia, Matthew B. Crist, Melissa Tobin D’Angelo, Brenda Sellers, Carlos Franco-Paredes, Monear Makvandi, Chad Smelser, John Greene, Danielle Stanek, Kimberly Signs, Randall J. Nett, Tom Chiller, and Benjamin J. Park
Table 1
Clinical characteristics of patients with Cryptococcus gattii infection outside the US Pacific Northwest, 2010–2012*
| Characteristic, n = 25† | No. (%)‡ |
|---|---|
| Demographic | |
| Male sex | 21 (84) |
| Sign or symptom | |
| Headache | 16 (67) |
| Blurred vision§ | 8 (62) |
| Nausea | 11 (46) |
| Fatigue | 11 (46) |
| Weight loss | 10 (42) |
| Vomiting | 10 (42) |
| Cough | 8 (33) |
| Fever | 7 (29) |
| Loss of appetite§ | 3 (25) |
| Neck stiffness | 5 (20) |
| Chills | 4 (17) |
| Dyspnea | 4 (17) |
| Night sweats | 3 (13) |
| Photophobia | 3 (13) |
| Chest pain§ | 1 (8) |
| Papilledema | 2 (8) |
| Muscle pain | 2 (8) |
| Seizure | 1 (4) |
| Underlying conditions (C. gattii molecular type) | |
| None | 16 (64) |
| Immunocompromising | 5 (20) |
| Pulmonary sarcoidosis (VGI) | 1 |
| Diabetes, liver transplant (VGIIb)# | 1 |
| Unspecified immunocompromising condition (VGIII)# | 1 |
| Congenital hyper-IgE, i.e., Job syndrome (VGI) | 1 |
| Active lung cancer, receiving chemotherapy (VGIII) | 1 |
| Other underlying condition | 4 (16) |
| History of prostate cancer, not on treatment (VGIII) | 1 |
| Diabetes, COPD, aortic stenosis (VGI) | 1 |
| Diabetes, RHD, restrictive lung disease, history of skin cancer (not on treatment) (VGI)# | 1 |
| Diabetes (VGIII) | 1 |
| Cryptococcomas (among those with images)§ | |
| Lung, n = 23 | 14 (61) |
| Brain, n = 20 | 10 (50) |
| Lung and brain, n = 18 | 5 (28) |
| Sites with evidence of infection | |
| Any CNS site (CSF or brain) | 19 (76) |
| Any pulmonary site (lung or sputa) | 9 (36) |
| CNS only | 12 (48) |
| CNS and pulmonary only | 3 (12) |
| Pulmonary only | 5 (20) |
| Blood only | 1 (4) |
| CNS and blood only | 2 (8) |
| CNS, blood, and pulmonary | 1 (4) |
| CNS and leg tissue | 1 (4) |
| Outcome | |
| Hospitalized | 23 (92) |
| ICU admission‡ | 10 (48) |
| Died of C. gattii infection | 6 (24) |
*COPD, chronic obstructive pulmonary disease; RHD, rheumatic heart disease; CNS, centeral nervous system; CSF, cerebrospinal fluid; ICU, intensive care unit.
†Patients’ median age was 43 years (range 15–83 years).
‡Proportions represent patients with available data. Complete data were not available for all patients.
§Data not available for all patients.
#Died of their cryptococcal infections.
Page created: September 20, 2013
Page updated: September 20, 2013
Page reviewed: September 20, 2013
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