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Update on Pulmonary Cryptococcosis

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Abstract

Pulmonary cryptococcosis is a common but underdiagnosed opportunistic fungal infection in both immunocompromised and immunocompetent patients. The causal agents include at least eight evolutionary distinct haploid lineages as well as their hybrids of the human pathogenic Cryptococcus complex. In this update, we review recent advances in epidemiology, mode of transmission, risk factors, diagnostic methods, and therapy of pulmonary cryptococcosis. Our review suggests significant challenges and opportunities for research, from bedside to benchside and back to bedside.

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References

  1. Acheson ES, Galanis E, Bartlett K, Mak S, Klinkenberg B. Searching for clues for eighteen years: deciphering the ecological determinants of Cryptococcus gattii on Vancouver Island, British Columbia. Med Mycol. 2018;56(2):129–44. https://doi.org/10.1093/mmy/myx037.

    Article  PubMed  Google Scholar 

  2. Akaihe CL, Nweze EI. Epidemiology of Cryptococcus and cryptococcosis in Western Africa. Mycoses. 2021;64(1):4–17. https://doi.org/10.1111/myc.13188.

    Article  PubMed  Google Scholar 

  3. Andreou M, Cogliati M, Kolonitsiou F, Stroumpos C, Stamouli V, Ravazoula P, Siagris D, Papadogeorgaki H, Christofidou M, Lekkou A. Cryptococcus gattii infection in an immunocompetent host in Greece. Med Mycol Case Rep. 2020;27:1–3. https://doi.org/10.1016/j.mmcr.2019.12.002.

    Article  PubMed  Google Scholar 

  4. Awari DW, Shah AS, Sexton AM, Sexton MA. Coinfection of Aspergillus and Cryptococcus in immunocompromised host: a case report and review of literature. Case Rep Infect Dis. 2020;2020:1–3. https://doi.org/10.1155/2020/8888270.

    Article  Google Scholar 

  5. Baddley JW, Forrest GN. Cryptococcosis in solid organ transplantation—guidelines from the American Society of transplantation infectious diseases community of practice. Clin Transpl. 2019;33(9): e13543. https://doi.org/10.1111/ctr.13543.

    Article  Google Scholar 

  6. Ballou ER, Johnston SA. The cause and effect of Cryptococcus interactions with the host. Curr Opin Microbiol. 2017;40:88–94. https://doi.org/10.1016/j.mib.2017.10.012.

    Article  CAS  PubMed  Google Scholar 

  7. Banshodani M, Marubayashi S, Shintaku S, Moriishi M, Tsuchiya S, Ohdan H, Kawanishi H. Isolated pulmonary Cryptococcosis confused with lung tumor 5 years after kidney transplantation: a case report. Transpl Proc. 2019;51(2):561–4. https://doi.org/10.1016/j.transproceed.2018.12.007.

    Article  CAS  Google Scholar 

  8. Bongomin F, Oladele RO, Gago S, Moore CB, Richardson MD. A systematic review of fluconazole resistance in clinical isolates of Cryptococcus species. Mycoses. 2018;61(5):290–7. https://doi.org/10.1111/myc.12747.

    Article  CAS  PubMed  Google Scholar 

  9. Boulware DR, Meya DB, Muzoora C, Rolfes MA, Huppler Hullsiek K, Musubire A, Taseera K, Nabeta HW, Schutz C, Williams DA, Rajasingham R, Rhein J, Thienemann F, Lo MW, Nielsen K, Bergemann TL, Kambugu A, Manabe YC, Janoff EN, Meintjes G. Timing of antiretroviral therapy after diagnosis of Cryptococcal meningitis. N Engl J Med. 2014;370(26):2487–98. https://doi.org/10.1056/nejmoa1312884.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Brochard J, Morio F, Mahe J, Le Pape P, Guimard T, Mahe B, Leterrier M, Morrier M, Raffi F, Boutoille D. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, a new risk factor for cryptococcosis. Medecine et Maladies Infectieuses. 2020;50(8):742–5. https://doi.org/10.1016/j.medmal.2020.07.005.

    Article  CAS  PubMed  Google Scholar 

  11. Cano EJ, Yetmar ZA, Raonable RR. Cryptococcus species other than Cryptococcus neoformans and Cryptococcus gattii: are they clinically significant? Open Forum Infect Dis. 2020;7(12):ofaa527.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Chang WC, Tzao C, Hsu HH, Lee SC, Huang KL, Tung HJ, Chen CY. Pulmonary cryptococcosis: comparison of clinical and radiographic characteristics in immunocompetent and immunocompromised patients. Chest. 2006;129(2):333–40. https://doi.org/10.1378/chest.129.2.333.

    Article  PubMed  Google Scholar 

  13. Chen CY, Sheng WH, Tien FM, Lee PC, Huang SY, Tang JL, Tsay W, Tien HF, Hsueh PR. Clinical characteristics and treatment outcomes of pulmonary invasive fungal infection among adult patients with hematological malignancy in a medical centre in Taiwan, 2008–2013. J Microbiol Immunol Infect. 2020;53(1):106–14. https://doi.org/10.1016/j.jmii.2018.01.002.

    Article  PubMed  Google Scholar 

  14. Chen M, Hong N, Hu S, Wang P, Guan HZ, Xiao M, Zhu X, Al-Hatmi AMS, Zhou Z, Gao L, Boekhout T, Xu J, Xu Y, Liao W, Yang Y. Molecular identification of Cryptococcus gattii from cerebrospinal fluid using single-cell sequencing: a case study. J Infect. 2020;81(4):634–8. https://doi.org/10.1016/j.jinf.2020.06.040.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Chen M, Xu N, Xu J. Cryptococcus neoformans meningitis cases among China’s HIV-infected population may have been severely under-reported. Mycopathologia. 2020;28:1–4. https://doi.org/10.1007/s11046-020-00491-4.

    Article  Google Scholar 

  16. Chen SCA, Meyer W, Sorrell TC. Cryptococcus gattii infections. Clin Microbiol Rev. 2014;27(4):980–1024. https://doi.org/10.1128/CMR.00126-13.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Cogliati M. Global molecular epidemiology of Cryptococcus neoformans and Cryptococcus gattii: an Atlas Of The Molecular Types. Scientifica. 2013;2013:1–23. https://doi.org/10.1155/2013/675213.

    Article  CAS  Google Scholar 

  18. Damsceno-Escoura AH, de Souza ML, de Olivera NF, Pardi TC, Gazotto FC, Florentino DH, Mora DJ, Silva-Vergara ML. Epidemiological, clinical and outcome aspects of patients with cryptococcosis caused by Cryptococcus gattii from a non-endmic area of Brazil. Mycopathologia. 2019;184(1):65–71. https://doi.org/10.1007/s11046-018-0304-3.

    Article  CAS  Google Scholar 

  19. Donnelly J, Chen SC, Kauffman CA, Steinbach WJ, Baddley JW, Verweij PE, Clancy CJ, Wingard JR, Lockhart SR, Groll AH, Sorrell TC, Bassetti M, Akan H, Alexander BD, Andes D, Azoulay E, Bialek R, Bradsher RW, Bretagne S, Pappas PG. Revision and update of the consensus definitions of invasive fungal disease from the european organization for research and treatment of cancer and the mycoses study group education and research consortium. Clin Infect Dis. 2020;71(6):1367–76. https://doi.org/10.1093/cid/ciz1008.

    Article  PubMed  Google Scholar 

  20. Farrer RA, Chang M, Davis MJ, van Dorp L, Yang DH, Shea T, Sewell TR, Meyer W, Balloux F, Edwards HM, Chanda D, Kwenda G, Vanhove M, Chang YC, Cuomo CA, Fisher MC, Kwon-Chung KJ. A new lineage of Cryptococcus gattii (VGV) discovered in the central zambezian miombo woodlands. MBio. 2019;10(6):e02306-e2319. https://doi.org/10.1128/mBio.02306-19.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Firacative C, Carvajal SK, Escandón P, Lizarazo J. Cryptococcosis in hematopoietic stem cell transplant recipients: a rare presentation warranting recognition. Can J Infect Dis Med Microbiol. 2020;2020:3713241. https://doi.org/10.1155/2020/3713241.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Fisher JF, Valencia-Rey PA, Davis WB. Pulmonary cryptococcosis in the immunocompetent patient-many questions, some answers. Open Forum Infect Dis. 2016;3(3):ofw167. https://doi.org/10.1093/ofid/ofw167.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Fujita J. Immune reconstitution inflammatory syndrome in the lung in non-human immunodeficiency virus patients. Respir Investig. 2020;58(1):36–44. https://doi.org/10.1016/j.resinv.2019.11.001.

    Article  PubMed  Google Scholar 

  24. Gassiep I, McDougall D, Douglas J, Francis R, Playford EG. Cryptococcal infections in solid organ transplant recipients over a 15-year period at a state transplant center. Transpl Infect Dis. 2017;19(1): e12639. https://doi.org/10.1111/tid.12639.

    Article  Google Scholar 

  25. Guarner J, Brandt ME. Histopathologic diagnosis of fungal infections in the 21st century. Clin Microbiol Rev. 2011;24(2):247–80. https://doi.org/10.1128/CMR.00053-10.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Guess TE, Rosen JA, McClelland EE. An overview of sex bias in C. neoformans infections. J Fungi. 2018;4(2):49. https://doi.org/10.3390/jof4020049.

    Article  CAS  Google Scholar 

  27. Gupta AO, Singh N. Immune reconstitution syndrome and fungal infections. Curr Opin Infect Dis. 2011;24(6):527–33. https://doi.org/10.1097/QCO.0b013e32834ab20a.

    Article  CAS  PubMed  Google Scholar 

  28. Hagen F, Colom MF, Swinne D, Tintelnot K, Iatta R, Montagna MT, Torres-Rodriguez JM, Cogliati M, Velegraki A, Burggraaf A, Kamermans A, Sweere JM, Meis JF, Klaassen CHW, Boekhout T. Autochthonous and dormant Cryptococcus gattii infections in Europe. Emerg Infect Dis. 2012;18(10):1618–24. https://doi.org/10.3201/eid1810.120068.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Hagen F, Khayhan K, Theelen B, Kolecka A, Polacheck I, Sionov E, Falk R, Parnmen S, Lumbsch HT, Boekhout T. Recognition of seven species in the Cryptococcus gattii/Cryptococcus neoformans species complex. Fungal Genet Biol. 2015;78:16–48. https://doi.org/10.1016/j.fgb.2015.02.009.

    Article  CAS  PubMed  Google Scholar 

  30. Hagen F, Lumbsch HT, Arsic Arsenijevic V, Badali H, Bertout S, Billmyre RB, Bragulat MR, Cabañes FJ, Carbia M, Chakrabarti A, Chaturvedi S, Chaturvedi V, Chen M, Chowdhary A, Colom M-F, Cornely OA, Crous PW, Cuétara MS, Diaz MR, Boekhout T. Importance of resolving fungal nomenclature: the case of multiple pathogenic species in the Cryptococcus genus. MSphere. 2017;2(4):238–55. https://doi.org/10.1128/msphere.00238-17.

    Article  CAS  Google Scholar 

  31. Hevey MA, George IA, Rauseo AM, Larson L, Powderly W, Spec A. Performance of the lateral flow assay and the latex agglutination serum Cryptococcal antigen test in Cryptococcal disease in patients with and without HIV. J Clin Microbiol. 2020;58(11):01563–620. https://doi.org/10.1128/JCM.01563-20.

    Article  Google Scholar 

  32. Hong N, Chen M, Xu J. Molecular markers reveal epidemiological patterns and evolutionary histories of the human pathogenic Cryptococcus. Front Cell Infect Microbiol. 2021;11:398. https://doi.org/10.3389/fcimb.2021.683670.

    Article  CAS  Google Scholar 

  33. Hou X, Kou L, Han X, Zhu R, Song L, Liu T. Pulmonary cryptococcosis characteristics in immunocompetent patients—a 20-year clinical retrospective analysis in China. Mycoses. 2019;62(10):937–44. https://doi.org/10.1111/myc.12966.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Khawcharoenporn T, Apisarnthanarak A, Mundy LM. Non-neoformans cryptococcal infections: a systematic review. Infection. 2007;35(2):51–8. https://doi.org/10.1007/s15010-007-6142-8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Kohno S, Kakeya H, Izumikawa K, Miyazaki T, Yamamoto Y, Yanagihara K, Mitsutake K, Miyazaki Y, Maesaki S, Yasuoka A, Tashiro T, Mine M, Uetani M, Ashizawa K. Clinical features of pulmonary cryptococcosis in non-HIV patients in Japan. J Infect Chemother. 2015;21(1):23–30. https://doi.org/10.1016/j.jiac.2014.08.025.

    Article  PubMed  Google Scholar 

  36. Kwon-Chung KJ, Bennett JE, Wickes BL, Meyer W, Cuomo CA, Wollenburg KR, Bicanic TA, Castañeda E, Chang YC, Chen J, Cogliati M, Dromer F, Ellis D, Filler SG, Fisher MC, Harrison TS, Holland SM, Kohno S, Kronstad JW, Lazera M, Levitz SM, Lionakis MS, May RC, Ngamskulrongroj P, Pappas PG, Perfect JR, Rickerts V, Sorrell TC, Walsh TJ, Williamson PR, Xu J, Zelazny AM, Casadevall A. The case for adopting the “Species Complex” nomenclature for the etiologic agents of Cryptococcosis. MSphere. 2017. https://doi.org/10.1128/msphere.00357-16.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kwon-Chung KJ, Saijo T. Is Cryptococcus gattii a primary pathogen? J Fungi. 2015;1(2):154–67. https://doi.org/10.3390/jof1020154.

    Article  Google Scholar 

  38. Lin KH, Chen CM, Chen TL, Kuo SC, Kao CC, Jeng YC, Ho MW. Diabetes mellitus is associated with acquisition and increased mortality in HIV-uninfected patients with cryptococcosis: a population-based study. J Infect. 2016;72(5):608–14. https://doi.org/10.1016/j.jinf.2016.01.016.

    Article  PubMed  Google Scholar 

  39. Liu XZ, Wang QM, Göker M, Groenewald M, Kachalkin AV, Lumbsch HT, Millanes AM, Wedin M, Yurkov AM, Boekhout T, Bai FY. Towards an integrated phylogenetic classification of the Tremellomycetes. Stud Mycol. 2015;81:85–147. https://doi.org/10.1016/j.simyco.2015.12.001.

    Article  PubMed  Google Scholar 

  40. M27Ed4: Broth Dilution Antifungal Susceptibility, Yeasts. (2017). https://clsi.org/standards/products/microbiology/documents/m27/

  41. M59Ed3 | Epidemiological Cutoff Values for Antifungal Susceptibility Testing, 3rd Edition. (2020). https://clsi.org/standards/products/microbiology/documents/m59/

  42. Montoya MC, Magwene PM, Perfect JR. Associations between cryptococcus genotypes, phenotypes, and clinical parameters of human disease: a review. J Fungi. 2021;7(4):260. https://doi.org/10.3390/jof7040260.

    Article  CAS  Google Scholar 

  43. Nayak R, Xu J. Effects of sertraline hydrochloride and fluconazole combinations on Cryptococcus neoformans and Cryptococcus gattii. Mycology. 2010;1:99–105.

    Article  CAS  Google Scholar 

  44. Nomura M, Ohta H, Hiruta M, Kudo F, Ohyanagi F, Yamamguchi Y. Steroid resistance in organzing pneumonia cause by pulmonary cryptococcosis. Respirology Case Reports. 2020;8(4): e00556. https://doi.org/10.1002/rcr2.556.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Pappas PG, Alexander BD, Andes DR, Hadley S, Kauffman CA, Freifeld A, Anaissie EJ, Brumble LM, Herwaldt L, Lto J, Kontoyiannis DP, Marshall Lyon G, Marr KA, Morrison VA, Park BJ, Patterson TF, Perl TM, Oster RA, Schuster MG, Chiller TM. Invasive fungal infections among organ transplant recipients: results of the transplant-associated infection surveillance network (Transnet). Clin Infect Dis. 2010;50(8):1101–11. https://doi.org/10.1086/651262.

    Article  PubMed  Google Scholar 

  46. Perfect JR, Dismukes WE, Dromer F, Goldman DL, Graybill JR, Hamill RJ, Harrison TS, Larsen RA, Lortholary O, Nguyen MH, Pappas PG, Powderly WG, Singh N, Sobel JD, Sorrell TC. Clinical practice guidelines for the management of cryptococcal disease: 2010 update by the infectious diseases society of America. Clin Infect Dis. 2010;50(3):291–322. https://doi.org/10.1086/649858.

    Article  PubMed  Google Scholar 

  47. Posteraro B, Vella A, Cogliati M, De Carolis E, Florio AR, Posteraro P, Sanguinetti M, Tortorano AM. Matrix-assisted laser desorption ionization-time of flight mass spectrometry-based method for discrimination between molecular types of Cryptococcus neoformans and Cryptococcus gattii. J Clin Microbiol. 2012;50(7):2472–6. https://doi.org/10.1128/JCM.00737-12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Qu J, Zhang X, Lu Y, Liu X, Lv X. Clinical analysis in immunocompetent and immunocompromised patients with pulmonary cryptococcosis in western China. Sci Rep. 2020;10(1):9387. https://doi.org/10.1038/s41598-020-66094-7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Rajasingham R, Smith RM, Park BJ, Jarvis JN, Govender NP, Chiller TM, Denning DW, Loyse A, Boulware DR. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect Dis. 2017;17(8):873–81. https://doi.org/10.1016/S1473-3099(17)30243-8.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Rajasingham R, Wake RM, Beyene T, Katende A, Letang E, Boulware DR. Cryptococcal meningitis diagnostics and screening in the era of point-of-care laboratory testing. J Clin Microbiol. 2019;57:e01238-e1318. https://doi.org/10.1128/JCM.01238-18.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Rhein J, Huppler Hullsiek K, Tugume L, Nuwagira E, Mpoza E, Evans EE, Kiggundu R, Pastick KA, Ssebambulidde K, Akampurira A, Williams DA, Bangdiwala AS, Abassi M, Musubire AK, Nicol MR, Muzoora C, Meya DB, Boulware DR, Ndyetukira JF, Nielsen K. Adjunctive sertraline for HIV-associated cryptococcal meningitis: a randomised, placebo-controlled, double-blind phase 3 trial. Lancet Infect Dis. 2019;19(8):843–51. https://doi.org/10.1016/S1473-3099(19)30127-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  52. Sah R, Jaiswal A, Singla S, Prakash AK, Mittal SK, Aggarwal A, Singh S, Neupane S, Sah S, Sah R, Neumayr A. Pulmonary cryptococcosis: Report of the first confirmed autochthonous case in Nepal. Acta Trop. 2020;202: 105205. https://doi.org/10.1016/j.actatropica.2019.105205.

    Article  CAS  PubMed  Google Scholar 

  53. Samarasinghe YAH, Aljohani R, Jimenez C, Xu J. Fantastic yeasts and where to find them: the discovery of a predominantly clonal Cryptococcus deneoformans population in Saudi Arabian soils. FEMS Microbiol Ecol. 2019;95(9):122. https://doi.org/10.1093/femsec/fiz122.

    Article  CAS  Google Scholar 

  54. Samarasinghe H, Xu J. Hybrids and hybridization in the Cryptococcus neoformans and Cryptococcus gattii species complexes. Infect Genet Evol. 2018;66:245–55. https://doi.org/10.1016/j.meegid.2018.10.011.

    Article  CAS  PubMed  Google Scholar 

  55. Samarasinghe H, You M, Jenkinson TS, Xu J, James TY. Hybridization facilitates adaptive evolution in two major fungal pathogens. Genes. 2020;11(1):101. https://doi.org/10.3390/genes11010101.

    Article  PubMed Central  Google Scholar 

  56. Samudralwar RD, Spec A, Cross AH. Fingolimod and cryptococcosis: Collision of immunomodulation with infectious disease. Int J MS Care. 2019;21(6):275–80. https://doi.org/10.7224/1537-2073.2018-080.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Setianingrum F, Rautemaa-Richardson R, Denning DW. Pulmonary cryptococcosis: a review of pathobiology and clinical aspects. Med Mycol. 2019;57(2):133–50. https://doi.org/10.1093/mmy/myy086.

    Article  PubMed  Google Scholar 

  58. Singh N, Alexander BD, Lortholary O, Dromer F, Gupta KL, John GT, Del Busto R, Klintmalm GB, Somani J, Lyon GM, Pursell K, Stosor V, Muñoz P, Limaye AP, Kalil AC, Pruett TL, Garcia-Diaz J, Humar A, Houston S, Husain S. Pulmonary cryptococcosis in solid organ transplant recipients: Clinical relevance of serum cryptococcal antigen. Clin Infect Dis. 2008;46(2): e12. https://doi.org/10.1086/524738.

    Article  PubMed  Google Scholar 

  59. Siqueira LPM, Gimenes VMF, De Freitas RS, Melhem DSC, M., Bonfietti, L. X., Da Silva, A. R., Santos, L. B. S., Motta, A. L., Rossi, F., Benard, G., & De Almeida, J. N. . Evaluation of vitek MS for differentiation of cryptococcus neoformans and cryptococcus gattii genotypes. J Clin Microbiol. 2019;57(1):e01282-e1318. https://doi.org/10.1128/JCM.01282-18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Skipper CP, Atukunda M, Stadelman A, Engen NW, Bangdiwala AS, Hullsiek KH, Abassi H, Rhein J, Nicol MR, Laker E, Williams DA, Mannino R, Matkovits T, Meya DB, Boulware DR. Phase I EnACT trail of the safety and tolerability of a novel oral formulation of amphotericin B. Antimicrob Ag Chemother. 2020;64(10): e00838. https://doi.org/10.1128/AAC.00838-20.

    Article  CAS  Google Scholar 

  61. Singh N, Alexander BD, Lortholary O, Dromer F, Gupta KL, John GT, Del Busto R, Klintmalm GB, Somani J, Lyon GM, Pursell K, Stosor V, Muňoz P, Limaye AP, Kalil AC, Pruett TL, Garcia-Diaz J, Humar A, Houston S, Lyon M. Cryptococcus neoformans in organ transplant recipients: Impact of calcineurin-inhibitor agents on mortality. J Infect Dis. 2007;195(5):756–64. https://doi.org/10.1086/511438.

    Article  PubMed  Google Scholar 

  62. Sionov E, Chang YC, Garraffo HM, Kwon-Chung KJ. Heteroresistance to fluconazole in Cryptococcus neoformans is intrinsic and associated with virulence. Antimicrob Ag Chemother. 2009;53(7):2804–15. https://doi.org/10.1128/AAC.00295-09.

    Article  CAS  Google Scholar 

  63. Steenbergen JN, Shuman HA, Casadevall A. Cryptococcus neoformans interactions with amoebae suggest an explanation for its virulence and intracellular pathogenic strategy in macrophages. Proc Nat Acad Sci. 2001;98(26):15245–50. https://doi.org/10.1073/pnas.261418798.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Sun HY, Wagener MM, Singh N. Cryptococcosis in solid-organ, hematopoietic stem cell, and tissue transplant recipients: evidence-Based evolving trends. Clin Infect Dis. 2009;48(11):1566–76. https://doi.org/10.1086/598936.

    Article  PubMed  Google Scholar 

  65. Takazono T, Saijo T, Ashizawa N, Oshima K, Nishimura K, Tashiro M, Yamamoto K, Imamura Y, Miyazaki T, Yanagihara K, Mukae H, Izumikawa K, Sheppard DC. Clinical features and cause analysis of false positive results of Aspergillus galactomannan assay in pulmonary cryptococcosis patients. Eur J Clin Microbiol Infect Dis. 2019;38(4):735–41. https://doi.org/10.1007/s10096-019-03469-3.

    Article  CAS  PubMed  Google Scholar 

  66. Tansarli GS, Chapin KC. Diagnostic test accuracy of the BioFire® FilmArray® meningitis/encephalitis panel: a systematic review and meta-analysis. Clin Microbiol Infect. 2020;26(3):281–90. https://doi.org/10.1016/j.cmi.2019.11.016.

    Article  CAS  PubMed  Google Scholar 

  67. Tashiro H, Haraguchi T, Takahashi K, Sadamatsu H, Tajiri R, Takamori A, Kimura S, Sueoka-Aragane N. Clinical impact of advanced chronic kidney disease in patients with non-HIV pulmonary cryptococcosis. BMC Pulm Med. 2020;20(1):116. https://doi.org/10.1186/s12890-020-1149-3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Temfack E, Rim JJB, Spijker R, Loyse A, Chiller T, Pappas PG, Perfect J, Sorell TC, Harrison TS, Cohen JF, Lortholary O. Cryptococcal antigen in serum and cerebrospinal fluid for detecting cryptococcal meningitis in adults living with HIV: systematic review and meta-analysis of diagnostic test accuracy studies. Clin Infect Dis. 2020;72(7):1268–78. https://doi.org/10.1093/cid/ciaa1243.

    Article  CAS  PubMed Central  Google Scholar 

  69. Thompson GR, Rendon A, Ribeiro Dos Santos R, Queiroz-Telles F, Ostrosky-Zeichner L, Azie N, Maher R, Lee M, Kovanda L, Engelhardt M, Vazquez JA, Cornely OA, Perfect JR. Isavuconazole treatment of Cryptococcosis and dimorphic mycoses. Clin Infect Dis. 2016;63(3):356–62. https://doi.org/10.1093/cid/ciw305.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Thornton CS, Larios O, Grossman J, Griener TP, Vaughan S. Pulmonary Cryptococcus infections as a manifestation of idiopathic CD4 lymphocytopenia: case report and literature review. BMC Infect Dis. 2019;19:862. https://doi.org/10.1186/s12879-019-4453-x.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Wang J, Hong JJ, Zhang PP, Yang MF, Yang Q, Qu TT. Cryptococcal pleuritis with pleural effusion as the only clinical presentation in a patient with hepatic cirrhosis: a case report and literature review. Medicine (USA). 2019;98(28): e16354. https://doi.org/10.1097/MD.0000000000016354.

    Article  Google Scholar 

  72. Wang Y, Xu J. Mitochondrial genome polymorphisms in the human pathogenic fungus Cryptococcus neoformans. Front Microbiol. 2020;11:706. https://doi.org/10.3389/fmicb.2020.00706.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Wei S, Su X, Pan YH, Zheng YY, Dong XW, Hu XH, Wu F, Shi Y. Postoperative antifungal treatment of pulmonary Cryptococcosis in non-HIV-infected and non-transplant-recipient patients: a report of 110 cases and literature review. Open forum Infect Dis. 2020;7(1):ofaa004. https://doi.org/10.1093/ofid/ofaa004.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Wei M, Xu YR, Liu K, Wen P. Anastrozole-induced pulmonary cryptococcosis in a patient with early breast cancer: a case report. Medicine (USA). 2020;99(2): e18688. https://doi.org/10.1097/MD.0000000000018688.

    Article  Google Scholar 

  75. Xie LX, Chen YS, Liu SY, Shi YX. Pulmonary cryptococcosis: Comparison of CT findings in immunocompetent and immunocompromised patients. Acta Radiol. 2015;56(4):447–53. https://doi.org/10.1177/0284185114529105.

    Article  PubMed  Google Scholar 

  76. Xu J. Fungal species concepts in the genomics era. Genome. 2020;63(9):459–68. https://doi.org/10.1139/gen-2020-0022.

    Article  PubMed  Google Scholar 

  77. Yang M, Zhang X, Hu J, Zhao H, Li L. Cryptococcosis in patients following kidney transplantation: a 9-year retrospective clinical analysis at a chinese tertiary hospital. Biomed Res Int. 2019;2019:7165160. https://doi.org/10.1155/2019/7165160.

    Article  PubMed  PubMed Central  Google Scholar 

  78. Yao K, Qiu X, Hu H, Han Y, Zhang W, Xia R, Wang L, Fang J. Pulmonary cryptococcosis coexisting with central type lung cancer in an immuocompetent patient: a case report and literature review. BMC Pulm Med. 2020;20:161. https://doi.org/10.1186/s12890-020-01200-z.

    Article  PubMed  PubMed Central  Google Scholar 

  79. Zafar H, Altamirano S, Ballou ER, Nielsen K. A titanic drug resistance threat in Cryptococcus neoformans. Curr Opin Microbiol. 2019;52:158–64. https://doi.org/10.1016/j.mib.2019.11.001.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Zaragoza O. Basic principles of the virulence of Cryptococcus. Virulence. 2019;10(1):490–501. https://doi.org/10.1080/21505594.2019.1614383.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Zavala S, Baddley JW. Cryptococcosis. Semin Respir Crit Care Med. 2020;41(1):69–79. https://doi.org/10.1055/s-0039-3400280.

    Article  PubMed  Google Scholar 

  82. Zhang Y, Zhang SX, Trivedi J, Toll AD, Brahmer J, Hales R, Bonerigo S, Zeng M, Li H, Yung RC. Pleural fluid secondary to pulmonary cryptococcal infection: a case report and review of the literature. BMC Infect Dis. 2019;19(1):710. https://doi.org/10.1186/s12879-019-4343-2.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Zhou B, She J, Yang L, Zhu B. Coexistent pulmonary cryptococcal infection and pulmonary sarcoidosis: a case report and literature review. J Int Med Res. 2020;48(2):1–6. https://doi.org/10.1177/0300060520903870.

    Article  Google Scholar 

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Acknowledgements

This work was supported by the Institute of Infectious Diseases Research at McMaster University

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Authors and Affiliations

  1. Microbiology Department, Hamilton Regional Laboratory Medicine Program, Hamilton General Hospital, Hamilton, ON, L8L 2X2, Canada

    Deborah Yamamura

  2. Department of Pathology and Molecular Medicine, McMaster University, Hamilton, L8S 4K1, Canada

    Deborah Yamamura

  3. Department of Biology, McMaster University, Hamilton, L8S 4K1, Canada

    Jianping Xu

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  1. Deborah Yamamura
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Yamamura, D., Xu, J. Update on Pulmonary Cryptococcosis. Mycopathologia 186, 717–728 (2021). https://doi.org/10.1007/s11046-021-00575-9

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