Cryptococcus gattii infections in multiple states outside the US Pacific Northwest.
Clonal VGII subtypes (outbreak strains) of Cryptococcus gattii have caused an outbreak in the US Pacific Northwest since 2004. Outbreak-associated infections occur equally in male and female patients (median age 56 years) and usually cause pulmonary disease in persons with underlying medical conditions. Since 2009, a total of 25 C. gattii infections, 23 (92%) caused by non-outbreak strain C. gattii, have been reported from 8 non-Pacific Northwest states. Sixteen (64%) patients were previously healthy, and 21 (84%) were male; median age was 43 years (range 15-83 years). Ten patients who provided information reported no past-year travel to areas where C. gattii is known to be endemic. Nineteen (76%) patients had central nervous system infections; 6 (24%) died. C. gattii infection in persons without exposure to known disease-endemic areas suggests possible endemicity in the United States outside the outbreak-affected region; these infections appear to differ in clinical and demographic characteristics from outbreak-associated C. gattii. Clinicians outside the outbreak-affected areas should be aware of locally acquired C. gattii infection and its varied signs and symptoms.
Julie R
JR
Harris
Shawn R
SR
Lockhart
Gail
G
Sondermeyer
Duc J
DJ
Vugia
Matthew B
MB
Crist
Melissa Tobin
MT
D'Angelo
Brenda
B
Sellers
Carlos
C
Franco-Paredes
Monear
M
Makvandi
Chad
C
Smelser
John
J
Greene
Danielle
D
Stanek
Kimberly
K
Signs
Randall J
RJ
Nett
Tom
T
Chiller
Benjamin J
BJ
Park
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003453:Cryptococcosis / Q000276:immunology / Q000382:microbiology / Q000401:mortality*; D056285:Cryptococcus gattii / Q000235:genetics / Q000276:immunology*; D004196:Disease Outbreaks; D005260:Female; D005838:Genotype; D006801:Humans; D008172:Lung Diseases, Fungal / Q000276:immunology / Q000382:microbiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D014481:United States / Q000453:epidemiology; D055815:Young Adult
Cryptococcus; Pacific Northwest; United States; fungal; fungi; gattii; meningitis; pneumonia