title: Evidence of zoonotic transmission of Cryptococcus neoformans from a pet cockatoo to an immunocompromised patient.
abstract: BACKGROUND
  Although cryptococcosis has been associated with birds for almost 50 years, point sources for infection have not been identified.
  
  
  OBJECTIVE
  To document zoonotic transmission of Cryptococcus neoformans.
  
  
  METHODS
  Case report.
  
  
  METHODS
  A home in Boston, Massachusetts.
  
  
  METHODS
  A 72-year-old woman who received a diagnosis of cryptococcal meningitis in November 1998. The patient, who had been taking immunosuppressant drugs since undergoing renal transplantation in 1989, owned a pet cockatoo.
  
  
  METHODS
  Cryptococcus neoformans was isolated from the feces of the cockatoo. Isolates from excreta and from the patient were compared by using biochemical profiles, monoclonal antibody binding patterns, restriction fragment length polymorphism analysis, and karyotyping.
  
  
  RESULTS
  The isolates from the patient and the cockatoo had identical biochemical profiles, the same monoclonal antibody immunofluorescence patterns, and indistinguishable patterns on restriction fragment length polymorphism analysis and karyotyping.
  
  
  CONCLUSIONS
  The indistinguishable patient and cockatoo isolates strongly suggest that the patient's infection resulted from exposure to aerosolized cockatoo excreta. Although the incidence of cryptococcal infection due to such exposure is unknown, it may be prudent to advise immunocompromised patients to avoid pet birds and avian excreta.
authors.affiliation: Albert Einstein College of Medicine, Bronx, New York 10461, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Nosanchuk
authors.forename: S
authors.initials: S
authors.lastname: Shoham
authors.forename: B C
authors.initials: BC
authors.lastname: Fries
authors.forename: D S
authors.initials: DS
authors.lastname: Shapiro
authors.forename: S M
authors.initials: SM
authors.lastname: Levitz
authors.forename: A
authors.initials: A
authors.lastname: Casadevall
mesh_terms: D000368:Aged; D000818:Animals; D000829:Animals, Domestic; D001717:Birds; D003453:Cryptococcosis / Q000635:transmission* / Q000662:veterinary; D003455:Cryptococcus neoformans / Q000145:classification / Q000302:isolation & purification; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D016030:Kidney Transplantation / Q000276:immunology; D012703:Serotyping; D015047:Zoonoses