Clinical Presentation, Diagnosis and Management of Cryptococcus gattii Cases: Lessons Learned from British Columbia

The environmental fungus Cryptococcus gattii emerged on Vancouver Island, British Columbia (BC), in 1999. By the end of 2006, it led to 176 cases and eight deaths – one of the highest burdens of C gattii disease worldwide. The present paper describes three cases, and the BC experience in the diagnos...

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Main Authors: Eleni Galanis, Linda Hoang, Pamela Kibsey, Muhammad Morshed, Peter Phillips
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Canadian Journal of Infectious Diseases and Medical Microbiology
Online Access:http://dx.doi.org/10.1155/2009/719659
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author Eleni Galanis
Linda Hoang
Pamela Kibsey
Muhammad Morshed
Peter Phillips
author_facet Eleni Galanis
Linda Hoang
Pamela Kibsey
Muhammad Morshed
Peter Phillips
author_sort Eleni Galanis
collection DOAJ
description The environmental fungus Cryptococcus gattii emerged on Vancouver Island, British Columbia (BC), in 1999. By the end of 2006, it led to 176 cases and eight deaths – one of the highest burdens of C gattii disease worldwide. The present paper describes three cases, and the BC experience in the diagnosis and management of this infection. All three cases presented with pulmonary findings, including cryptococcomas and infiltrates. One also presented with brain cryptococcomas. Cases were diagnosed by chest and brain imaging, and laboratory evidence including serum or cerebrospinal fluid cryptococcal antigen detection and culture of respiratory or cerebrospinal fluid specimens. Genotyping of fungal isolates confirmed infection with C gattii VGIIa. Pulmonary cases were treated with fluconazole. One patient with central nervous system disease was treated with amphotericin B followed by fluconazole. Although this infection remains rare, clinicians should be aware of it in patients with a compatible clinical presentation who are either living in or returning from a trip to BC.
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spelling doaj-art-aea5e4c98ddf4e73a8f62d71def4b13d2025-08-20T03:38:59ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95322009-01-01201232810.1155/2009/719659Clinical Presentation, Diagnosis and Management of Cryptococcus gattii Cases: Lessons Learned from British ColumbiaEleni Galanis0Linda Hoang1Pamela Kibsey2Muhammad Morshed3Peter Phillips4BC Centre for Disease Control, CanadaBC Centre for Disease Control, CanadaVancouver Island Health Authority, Victoria, CanadaBC Centre for Disease Control, CanadaUniversity of British Columbia, Vancouver, CanadaThe environmental fungus Cryptococcus gattii emerged on Vancouver Island, British Columbia (BC), in 1999. By the end of 2006, it led to 176 cases and eight deaths – one of the highest burdens of C gattii disease worldwide. The present paper describes three cases, and the BC experience in the diagnosis and management of this infection. All three cases presented with pulmonary findings, including cryptococcomas and infiltrates. One also presented with brain cryptococcomas. Cases were diagnosed by chest and brain imaging, and laboratory evidence including serum or cerebrospinal fluid cryptococcal antigen detection and culture of respiratory or cerebrospinal fluid specimens. Genotyping of fungal isolates confirmed infection with C gattii VGIIa. Pulmonary cases were treated with fluconazole. One patient with central nervous system disease was treated with amphotericin B followed by fluconazole. Although this infection remains rare, clinicians should be aware of it in patients with a compatible clinical presentation who are either living in or returning from a trip to BC.http://dx.doi.org/10.1155/2009/719659
spellingShingle Eleni Galanis
Linda Hoang
Pamela Kibsey
Muhammad Morshed
Peter Phillips
Clinical Presentation, Diagnosis and Management of Cryptococcus gattii Cases: Lessons Learned from British Columbia
Canadian Journal of Infectious Diseases and Medical Microbiology
title Clinical Presentation, Diagnosis and Management of Cryptococcus gattii Cases: Lessons Learned from British Columbia
title_full Clinical Presentation, Diagnosis and Management of Cryptococcus gattii Cases: Lessons Learned from British Columbia
title_fullStr Clinical Presentation, Diagnosis and Management of Cryptococcus gattii Cases: Lessons Learned from British Columbia
title_full_unstemmed Clinical Presentation, Diagnosis and Management of Cryptococcus gattii Cases: Lessons Learned from British Columbia
title_short Clinical Presentation, Diagnosis and Management of Cryptococcus gattii Cases: Lessons Learned from British Columbia
title_sort clinical presentation diagnosis and management of cryptococcus gattii cases lessons learned from british columbia
url http://dx.doi.org/10.1155/2009/719659
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