Cryptococcosis: Epidemiology, Diagnosis, and Treatment of a Systemic Mycosis in Immunocompetent and Immunocompromised Patients

Abstract

INTRODUCTION: Cryptococcosis is a systemic fungal infection caused by fungi of the genus Cryptococcus, with Cryptococcus neoformans and Cryptococcus gattii being the primary pathogens affecting humans. The infection is predominantly acquired through inhalation of spores from contaminated soil, primarily impacting immunocompromised individuals, especially those with AIDS, and, to a lesser extent, immunocompetent persons. This study aims to review the literature on cryptococcosis, covering epidemiological, diagnostic, and therapeutic aspects. METHODOLOGY: An extensive search was conducted in scientific databases such as PubMed, Scopus, Web of Science, and Google Scholar using keywords related to the disease. Articles published in the last fifteen years (2009-2024) were selected, prioritizing peer-reviewed studies, clinical trials, systematic reviews, and meta-analyses. The analysis focused on the relevance, methodological quality, and contribution to the understanding of cryptococcosis. DEVELOPMENT: Cryptococcosis pathogenesis occurs through the inhalation of basidiospores or desiccated yeasts, which transform into encapsulated yeasts within the pulmonary alveoli. Clinical manifestations vary based on infection location and the patient’s immune status, with common forms including pneumonia, meningoencephalitis, and skin lesions. Diagnosis is performed through mycological examination, culture, and antigen tests, with treatment tailored to the clinical presentation and fungal species, utilizing antifungals such as fluconazole and amphotericin B. CONCLUSION: Despite advancements in diagnosis and treatment, cryptococcosis continues to pose a significant challenge, especially in immunocompromised patients. A multidisciplinary approach is crucial for effective disease management, including early diagnosis, appropriate treatment, and ongoing monitoring.