Cryptococcus gattii Species Complex as an Opportunistic Pathogen: Underlying Medical Conditions Associated with the Infection
Dong-Hoon Yang, Matthew R. England, Hélène Salvator, Seher Anjum, Yoon‐Dong Park, Kieren A. Marr, Laurie A. Chu, Nelesh P. Govender, Shawn R. Lockhart, Marie Desnos‐Ollivier, Sharon Chen, Catriona Halliday, Alex Kan, Jianghan Chen, Kurt Wollenberg, Adrian M. Zelazny, John R. Perfect, Yun C. Chang, John E. Bennett, Steven M. Holland, Wieland Meyer, Peter R. Williamson, Kyung J. Kwon‐Chung
Abstract
The C. neoformans and C. gattii species complex causes cryptococcosis. The C. neoformans species complex is known as an opportunistic pathogen since it primarily infects immunocompromised patients. C. gattii species complex has been referred to as a primary pathogen due to its high infection frequency in apparently immunocompetent people. We analyzed 135 global cases of C. gattii infection with documented patient history. Eighty-six of 135 patients were originally diagnosed as immunocompetent and 49 as immunosuppressed with similar underlying conditions reported for C. neoformans infection. A significant number of C. gattii patients without known underlying conditions possessed autoantibodies against granulocytes-macrophage colony-stimulating factor (GM-CSF) in their plasma, supporting the presence of GM-CSF antibodies as a hidden risk factor for C. gattii infection. No relationship was found between C. gattii lineages and the underlying conditions except for overrepresentation of the molecular type VGIV among HIV+ patients due to the prevalence of VGIV in Africa.