Cryptococcose généralisée

Disseminated cryptococcosis is a systemic fungal infection caused by encapsulated yeasts of the genus Cryptococcus, most often C. neoformans or C. gattii, and is distinguished from localized cutaneous forms by systemic rather than skin-confined involvement ^[1][2]. It may present with cutaneous manifestations as part of wider dissemination ^[2].

Cryptococcal meningitis is the most frequent human manifestation of cryptococcosis, and disseminated disease has been observed in previously healthy HIV-negative adults with neutralizing anti-GM-CSF autoantibodies ^[1]. Cutaneous involvement may indicate localized disease or disseminated/systemic cryptococcosis, a distinction clinicians consider more relevant than infection route ^[2]. The organism can persist undetected in weakened hosts, potentially progressing to life-threatening meningitis ^[3].

Localized cutaneous cryptococcosis is uncommon in Japan, with only 65 cases reported over a 50-year study period from 1968 to August 2018 ^[2]. Among these cases, 68% (n=44) occurred in immunocompromised patients and 32% (n=21) in immunocompetent patients, with none associated with human immunodeficiency virus (HIV) infection ^[2]. Consequently, localized cutaneous cryptococcosis affects both immunocompromised and well-appearing non-HIV-infected individuals, establishing its relevance in routine dermatology practice ^[2].

Cryptococcus is acquired from the environment and is difficult to avoid breathing in where it is present, though most exposed persons do not become ill ^[3].

No formal general recommendation exists to prevent cryptococcal infection because environmental exposure is hard to avoid ^[3]. For people with advanced HIV, targeted cryptococcal-antigen blood screening with antifungal treatment when antigen is detected can prevent severe or life-threatening disease ^[3]. Persons with possible cryptococcal symptoms should seek medical evaluation promptly ^[3].

1. 1 Arango-Franco CA et al. Anti-GM-CSF Neutralizing Autoantibodies in Colombian Patients with Disseminated Cryptococcosis. J Clin Immunol. 2023 Jul. PMID: 36821021. doi: 10.1007/s10875-023-01451-5. PubMed: https://pubmed.ncbi.nlm.nih.gov/36821021/
2. 2 Noguchi H et al. Cutaneous Cryptococcosis. Med Mycol J. 2019. PMID: 31787730. doi: 10.3314/mmj.19.008. PubMed: https://pubmed.ncbi.nlm.nih.gov/31787730/
3. 3 US Centers for Disease Control and Prevention. Reducing Risk for Cryptococcosis | Cryptococcosis | CDC [Internet]. cited 23 Oct 2026. Available from: https://www.cdc.gov/cryptococcosis/prevention/index.html