Ubiquitous organism in soil rich in organic nutrients such as decaying vegetation and bird droppings.

Survival of cryptococcal cells in the environment and in hosts depends on the presence of its capsule and the production of the antioxidant melanin.

4 serotypes of Cryptococcus neoformans, A, B, C and D.

Groups A and D are dominant species worldwide.

Cryptococcal cells are yeasts.

Cells have small capsules.

Cryptococcosis an infection most often seen in the US in patients with advanced HIV infection.

Associated with HIV infection, idiopathic CD4 lymphocytopenia, transplantation, malignancy, connective tissue disease, glucocorticosteroid therapy, COPD, cirrhosis, and sarcoidosis.

Glucocorticosteroid therapy associated with up to 30% of cases of cryptococcal infections in patients who are HIV negative.

Infection begins with inhalation of basidiospores of the fungus.

Diagnosis requires biopsy as crytotococcal antigen assay is inadequate.

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