Cryptococcus neoformàns var. gattii among patients with cryptococcal meningitis in Mexico. First observations

Abstract

A retrospective study of 20 patients with cryptococcal meningitis and their isolated strains was performed. Cryptococcus neoformans var. neoformans was recovered from 14 (70%) cases, and var. gattii was recovered from six (30%) patients. Twelve patients had AIDS (all carrying var. neoformans), two had other diseases (one with var. neoformans and one var. gattii) and there was no identifiable underlying disease in six (one var. neoformans and five var. gattii). Fourteen patients (11 var. neoformans and three var. gattii) resided in the Mexico City area, where a temperate climate is prevalent, and there were six cases (three var. neoformans and three var. gattii) from states with a tropical/subtropical climate. Although there was no significant statistical difference between the two varieties, the fatal outcome was higher in patients with var. neoformans. The disease caused by var. gattii strains was characterized by a higher opening pressure, more inflamatory changes of CSF and a longer clinical course (delayed clinical and mycological cure). Cryptococcus neoformans var. gattii is a significant cause of cryptococcal meningitis in patients without underlying diseases in Mexico.

Cryptococcus gattii in the United States: Genotypic Diversity of Human and Veterinary Isolates

“… C . gattii infections often require lengthier treatments and more aggressive interventions [1,2,66–68], making distinction of these infections from C. neoformans infections extremely important.…”

Fatal Disseminated Cryptococcus gattii Infection in New Mexico

“…In addition, the annual temperature has also been above average, with a median temperature of 58 degrees Fahrenheit [25]. New Mexico has regions similar to those in Mexico known to harbor C. gattii [26]–[29], whereas the foothills of the Rocky Mountains, which run through Albuquerque, may represent a more temperate climate niche. Environmental sampling in the Pacific Northwest demonstrated that C. gattii has established ecological niches in trees other than Eucalyptus , including species of fir, maple, alder, cedar, spruce, pine and oak trees [10], [24].…”

Encephalomyelitis due to Cryptococcus neoformans var gattii presenting as spinal tumour: case report and review of the literature

“…Therefore infection with C neoformans var gattii is mainly reported from Australia and the South Pacific, the United States, Latin America, and Sub-Saharian Africa 1-1012 15 Although de novo infections with C neoformans var gattii in Europe have been suggested,16-18 most infections in Europeans were probably acquired outside Europe. As a result of an increasing exportion of Eucalyptus trees from Mediterranean countries (for example, Morocco, Tunesia, Italy, Spain, Portugal, Greece) and India an expanding distribution of C neoformans var gattii is seen 13…”