Skip to main content

Advertisement

SpringerLink
Log in

First Autochthonous Case of Cryptococcal Meningitis in an Immunocompetent Host Due to Cryptococcus gattii VGIin Northern Italy

  • Medicine
  • Published:
SN Comprehensive Clinical Medicine Aims and scope Submit manuscript

Abstract

We describe a case of cryptococcal meningitis diagnosed in an immunocompetent patient, with no apparent predisposing conditions, living in Northern Italy. The patient was initially admitted for visual disturbs with nausea and cervical pain, but magnetic resonance imaging of the brain showed a diencephalic lesion. Colonies of Cryptococcus gattii species complex were isolated from cerebrospinal fluid. Antifungal therapy was started and conditions of the patient improved in 2 months. The fungal isolate was identified as C. gattii molecular type VGI, mating type αB, and genotype ST156. This is the most common C. gattii species complex genotype circulating in Europe and in Italy suggesting that the infection was probably acquired in Italy since the patient did not report any recent travel abroad.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kwon-Chung KJ, Fraser JA, Doering TL, et al. Cryptococcus neoformans and Cryptococcus gattii, the etiologic agents of cryptococcosis. Cold Spring Harb Perspect Med. 2014;4:a019760.

    Article  Google Scholar 

  2. Velagapudi R, Hsueh YP, Geunes-Boyer S, Wright JR, Heitman J. Spores as infectious propagules of Cryptococcus neoformans. Infect Immun. 2009;77:4345–55.

    Article  CAS  Google Scholar 

  3. Rajasingham R, Smith RM, Park BJ, Jarvis JN, Govender NP, Chiller TM, et al. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect Dis. 2017;17:873–81.

    Article  Google Scholar 

  4. Beardsley J, Sorrell TC, Chen SC. Central nervous system cryptococcal infections in non-HIV infected patients. J Fungi (Basel). 2019;5:pii: E71.

    Article  Google Scholar 

  5. Chen SC, Meyer W, Sorrell TC. Cryptococcus gattii infections. Clin Microbiol Rev. 2014;27:980–1024.

    Article  CAS  Google Scholar 

  6. Cogliati M. Global molecular epidemiology of Cryptococcus neoformans and Cryptococcus gattii: an atlas of the molecular types. Scientifica (Cairo). 2013;2013:675213.

    Google Scholar 

  7. Engelthaler DM, Hicks ND, Gillece JD, Roe CC, Schupp JM, Driebe EM, et al. Cryptococcus gattii in North American Pacific Northwest: whole-population genome analysis provides insights into species evolution and dispersal. MBio. 2014;5:e01464–14.

    Article  Google Scholar 

  8. 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;56:129–44.

    Article  Google Scholar 

  9. Cogliati M, D’Amicis R, Zani A, et al. Environmental distribution of Cryptococcus neoformans and C. gattii around the Mediterranean basin. FEMS Yeast Res. 2016;16:pii: fow086.

    Article  Google Scholar 

  10. Montagna MT, Tortorano AM, Fiore L, et al. Cryptococcus neoformans var. gattii en Italie. Note I. Premier cas autochtone de méningite de sérotype B chez un sujet VIH positif. J Mycol Méd. 1997;7:90–2.

    Google Scholar 

  11. Tortorano AM, Viviani MA, Rigoni AL, et al. Prevalence of serotype D in Cryptococcus neoformans isolates from HIV positive and HIV negative patients in Italy. Mycoses. 1997;40:297–302.

    Article  CAS  Google Scholar 

  12. Iatta R, Hagen F, Fico C, Lopatriello N, Boekhout T, Montagna MT. Cryptococcus gattii infection in an immunocompetent patient from Southern Italy. Mycopathologia. 2012;174:87–92.

    Article  Google Scholar 

  13. Cogliati M, Allaria M, Tortorano AM, Viviani MA. Genotyping Cryptococcus neoformans var. neoformans with specific primers designed from PCR-fingerprinting bands sequenced using a modified PCR-based strategy. Med Mycol. 2000;38:97–103.

    Article  CAS  Google Scholar 

  14. Esposto MC, Cogliati M, Tortorano AM, Viviani MA. Determination of Cryptococcus neoformans var. neoformans mating type by multiplex PCR. Clin Microbiol Infect. 2004;10:1092–4.

    Article  CAS  Google Scholar 

  15. Meyer W, Aanensen DM, Boekhout T, Cogliati M, Diaz MR, Esposto MC, et al. Consensus multi-locus sequence typing scheme for Cryptococcus neoformans and Cryptococcus gattii. Med Mycol. 2009;47:561–70.

    Article  CAS  Google Scholar 

  16. Cogliati M, Desnos-Ollivier M, McCormick-Smith I, et al. Genotypes and population genetics of Cryptococcus neoformans and Cryptococcus gattii species complexes in Europe and the Mediterranean area. Fungal Genet Biol. 2019;129:16–29.

    Article  Google Scholar 

  17. Montagna MT, De Donno A, Caggiano G, et al. Molecular characterization of Cryptococcus neoformans and Cryptococcus gattii from environmental sources and genetic comparison with clinical isolates in Apulia. Italy Environ Res. 2018;160:347–52.

    Article  CAS  Google Scholar 

  18. Santander XA, Gutiérrez-González R, Cotúa C, et al. Intraventricular cryptococcoma mimicking a neoplastic lesion in an immunocompetent patient with hydrocephalus: a case report. Surg Neurol Int. 2019;10:115.

    Article  Google Scholar 

  19. Khattab A, Patruni S, Sealey ML. Rare presentation of cryptococcal meningitis in an immunocompetent patient. BMJ Case Rep. 2019;12:pii: e230003.

    Article  Google Scholar 

  20. Kwon-Chung KJ, Saijo T. Is Cryptococcus gattii a primary pathogen? J Fungi (Basel). 2015;1:154–67.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. UOC Microbiologia e Virologia, ASST Papa Giovanni XXIII, Bergamo, Italy

    Marco Passera & Claudio Farina

  2. USC Neurologia, ASST Papa Giovanni XXIII, Bergamo, Italy

    Virginio Bonito

  3. UOC Malattie Infettive, ASST Papa Giovanni XXIII, Bergamo, Italy

    Laura Comi

  4. UO Medicina Interna, Policlinico San Marco GDS (Gruppo San Donato), Zingonia, BG, Italy

    Elisa Calvi

  5. USC Neuroradiologia, ASST Papa Giovanni XXIII, Bergamo, Italy

    Ornella Manara

  6. Laboratorio Micologia Medica, Dipartimento Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal 36, 20133, Milan, Italy

    Massimo Cogliati

Authors
  1. Marco Passera
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Virginio Bonito
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laura Comi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elisa Calvi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ornella Manara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Claudio Farina
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Massimo Cogliati
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Massimo Cogliati.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

Ethical approval is not required for this study.

Informed Consent

The patient expressed an informed consent for the publication of the present case report.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Medicine

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Passera, M., Bonito, V., Comi, L. et al. First Autochthonous Case of Cryptococcal Meningitis in an Immunocompetent Host Due to Cryptococcus gattii VGIin Northern Italy. SN Compr. Clin. Med. 2, 237–241 (2020). https://doi.org/10.1007/s42399-019-00208-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s42399-019-00208-9

Keywords

Search

Navigation