Evidence of Zoonotic Transmission of<i>Cryptococcus neoformans</i>from a Pet Cockatoo to an Immunocompromised Patient

Nosanchuk, Joshua D.; Shoham, Shmuel; Fries, Bettina C.; Shapiro, Daniel S.; Levitz, Stuart M.; Casadevall, Arturo

doi:10.7326/0003-4819-132-3-200002010-00006

Cited by 144 publications

(93 citation statements)

References 15 publications

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“…Molecular studies indicate that cryptococcosis in African individuals living in Europe are the result of reactivation of latent infection. 23 In contrast, a case of apparent C neoformans infection from a pet cockatoo was recently reported 24 suggesting that for some patients symptomatic C neoformans infection represents either a primary progressive infection or a reinfection.…”

Section: Discussionmentioning

confidence: 99%

Serologic Evidence forCryptococcus neoformansInfection in Early Childhood

et al. 2001

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ABSTRACT. Objective. Cryptococcus neoformans is an important cause of central nervous system infection in adults with acquired immunodeficiency syndrome (AIDS) but an unusual cause of disease in children with AIDS. The basis for this age-related difference in incidence is not known but may be caused by differences in exposure or immune response. The objective of this study was to determine whether the low prevalence of cryptococcal disease among children is related to a lack of exposure to C neoformans.Methods. Sera were obtained from 185 immunocompetent individuals ranging in age from 1 week to 21 years who were being evaluated in an urban emergency department. Sera were analyzed for antibodies to C neoformans and Candida albicans proteins by immunoblotting. Immunoblot patterns were compared with those obtained from sera of patients with cryptococcosis (n ‫؍‬ 10) and workers in a laboratory devoted to the study of C neoformans. The specificity of our results was confirmed by several approaches, including antibody absorption and blocking studies. Sera were also analyzed for the presence of cryptococcal polysaccharide by both enzyme-linked immunosorbent assay and latex agglutination assays.Results. Sera from children 1.1 to 2 years old demonstrated minimal reactivity to C neoformans proteins. In contrast, the majority of sera from children >2 years old recognized many (>6) C neoformans proteins. For children between 2.1 and 5 years old, 56% of sera (n ‫؍‬ 25) reacted with many proteins, whereas for children >5 years old (n ‫؍‬ 120), 70% of samples reacted with many proteins. Reactivity was decreased by absorbing sera with C neoformans extracts or by preincubating blots with sera from experimentally infected but not from control rats. Reactivity to C neoformans proteins did not correlate with reactivity to C albicans proteins, which was common in sera from children between the ages of 1.1 and 2 years. Cryptococcal polysaccharide was detected at a titer of 1:16 (ϳ10 ng/mL) in the sera of 1 child, a 5.6-year-old boy who presented to the emergency department with vomiting.Conclusions. Our findings provide both indirect and direct evidence of C neoformans infection in immunocompetent children. Our results indicate that C neoformans infects a majority of children living in the Bronx after 2 years old. These results are consistent with several observations: the ubiquitous nature of C neoformans in the environment, including its association with pigeon excreta; the large number of pigeons in urban areas; and the increased likelihood of environmental exposure for children once they have learned to walk. The signs and symptoms associated with C neoformans infection in immunocompetent children remained to be determined. Primary pulmonary cryptococcosis may be asymptomatic or produce symptoms confused with viral infections and, therefore, not recognized as a fungal infection. Our results suggest that the low incidence of symptomatic cryptococcal disease in children with AIDS is not a result of lack of exposure to C neoforman...

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Section: Discussionmentioning

confidence: 99%

Serologic Evidence forCryptococcus neoformansInfection in Early Childhood

et al. 2001

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“…Although pigeon droppings have been documented as the major source of C. neoformans in nature, the presence of this yeast in many bird species other than pigeons, i.e., dove, psitaccines, budgerigars, canaries, parrots, cockatoos and starlings had also been reported 2,7,13,20,21,25 . In previous studies from Iran, C. neoformans was also isolated in 17.8% 10 and 34% 28 of pigeon droppings.…”

Section: Discussionmentioning

confidence: 99%

Cryptococcus neoformans isolation from swallow (Hirundo rustica) excreta in Iran

Hedayati

Mayahi

Fakhar

et al. 2011

Rev. Inst. Med. trop. S. Paulo

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SUMMARYCryptococcus neoformans is an encapsulated yeast that can cause cryptococcosis, a life-threatening infection that mainly occurs in immunocompromised patients. The major environmental sources of C. neoformans have been shown to be soil contaminated with avian droppings. In the present study, we evaluated the isolation of C. neoformans from swallow (Hirundo rustica) excreta in two northern cities of Iran. Ninety-seven swallow droppings were evaluated and 498 yeast-like colonies were isolated and identified as Rhodotorula spp. (62.8%), Candida spp. (28.5%) and C. neoformans (8.7%). Cryptococcus neoformans was isolated from 5/97 (5.2%) of collected samples. Min-Max colony forming units (CFU) per one gram for the positive samples were 3-10 C. neoformans colonies. The total mean CFU per one gram for the positive samples was 4.8. The results of this study demonstrate that excreta of swallow may harbor different species of potentially pathogenic yeasts, mainly C. neoformans, and may be capable of disseminating these fungi in the environment.

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“…Although rare reports have epidemiologically linked human cryptococcosis to bird exposure, in the vast majority of cases, the source of the fungus is never determined (1,22). From a medical standpoint, a greater understanding of the ecological niches of C. neoformans is important because it could lead to commonsense recommendations so that immunocompromised persons at high risk of infection can minimize exposure to this opportunistic fungus.…”

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confidence: 99%

“…Based on the finding that C. neoformans can be isolated from the excreta of virtually all species of birds studied, it has long been thought that birds are important in propagating C. neoformans (1,22). Interestingly, the birds themselves do not get infected, perhaps because their high body temperature is inhospitable to the growth of the fungus.…”

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confidence: 99%

Evidence of Zoonotic Transmission ofCryptococcus neoformansfrom a Pet Cockatoo to an Immunocompromised Patient

Cited by 144 publications

References 15 publications

Serologic Evidence forCryptococcus neoformansInfection in Early Childhood

Serologic Evidence forCryptococcus neoformansInfection in Early Childhood

Cryptococcus neoformans isolation from swallow (Hirundo rustica) excreta in Iran

Does amoeboid reasoning explain the evolution and maintenance of virulence factors in Cryptococcus neoformans ?

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