What is the role of cryptococcal infection in the ocular manifestations of HIV infection?

Updated: Jun 12, 2019
  • Author: Robert A Copeland, Jr, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Cryptococcus neoformans is a budding, spore-forming, yeastlike fungus, with a diameter of 5-10 µm. A clear mucinous capsule usually surrounds this organism. This capsule can be detected easily by India ink and mucicarmine preparations. The distribution of the organism is worldwide. Infection from C neoformans most frequently is acquired from pigeon or other bird droppings. This organism has been isolated from soil, fruit, and milk.

Cryptococcal infection occurs by inhalation of airborne spores. Organisms initially remain in the lungs, then spread hematogenously to other parts of the body. This organism has predilection for the brain and meninges. Intraocular infection may occur either via direct extension from the CNS or through the bloodstream from a localized or disseminated cryptococcal infection.

Most intraocular cryptococcal infections have been seen in association with cryptococcal septicemia with severe meningeal infection. This often occurs in immunocompromised individuals or debilitated patients (eg, HIV-positive patients or patients with malignant lymphoma, Hodgkin lymphoma, or systemic lupus erythematosus).

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