44 CNS Infections
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Cryptococcus
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- thick capsule evade immune system
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- Egyptian crypt for cryptococcus
- coffins: Yeast are round and heavily encapsulated
- repeating pattern on coffin: Cryptococcus capsule has a repeating polysaccharide capsular antigen. Main virulence factor for antiphagocytes
- NH3 spray bottle: Urease positive
- pigeons with droppings. Archaeologists coughing: Cryptococcus is inhaled from soil and/or pigeon droppings. Settles in lungs
- cane: Immunocompromised (HIV)
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- different from bacterial (abrupt onset)
- important: raise ICP, risk of herniation
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- archaeologists coughing: Pulmonary Crypto causes cough and dyspnea
- Neck brace: Can cause cryptococcosis, a fungal meningitis. Most common cause of fungal meningitis
- sweating: fever
- frogs, pinecone, with flute: flucytosine/amphoterecin B joint treatment with maintenaince fluconazole
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- soap bubbles on lung: Diagnose with a microscopic exam of bronchopulmonary washing
- red and silver stripes: Diagnosis of pulmonary Crypto can be aided by mucicarmine or methenamine silver stain
- vase with bubbling tar: India Ink test can diagnose Crypto meningitis with lumbar puncture/CSF. Background dark, transparent organism
- latex gloves next to repeating patterns: Latex agglutination test detects polysaccharide capsular antigens and causes their agglutination
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- soap bubbles on head: Causes "soap bubble" lesions in gray matter
PML
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