Health officials in Quebec, Canada believe they have detected the 1st autochthonous human case of Cryptococcus gattii infection in Eastern Canada in a Montreal woman.

Quebec map/EOZyo
Quebec map/EOZyo

According to the case report, a previously healthy 20-year old female presented with a 4-week history of worsening headaches. A lumbar puncture showed an opening pressure of 47 mm Hg and CSF cultures were positive for Cryptococcus gattii (confirmed by molecular sequencing). She was diagnosed with Cryptococcus gattii meningoencephalitis.

The patient had no travel history outside the province of Quebec. She worked in a pet shop where she had direct contact with several animals. An extensive investigation performed by local authorities of animal feces, bird droppings, and the pet store’s environment did not identify the yeast. The chance of work-related infection cannot be confirmed or ruled-out with certainty in this case.

C.gattii is a fungus, more specifically a yeast, which is considered an emerging pathogen in the Pacific Northwest. However, it has been reported outside of the region, including in California, Florida, New York and Georgia, among other places.

What is the difference between C. gattii and Cryptococcus neoformans?

They are closely related but very distinct species. Though there is quite a bit of overlap, what appear to be the biggest differences of interest are the ecological niches for each and the types of patients that they cause disease in.

C.neoformans is notorious for being present in bird droppings, pigeon nests and soil while the presence of C. gattii is frequently isolated from tree bark and tree hollows.

C. neoformans is primarily a disease of people with a compromised immune system while the newest discovery of the genome found in the Pacific Northwest appears to cause pathology on healthy people who are immunocompetent.

Like its sister, C. neoformans, C. gattii is picked up by inhalation of the fungus. Fortunately there is no person to person transmission. Symptoms appear after a couple months to a year.

Respiratory symptoms, which would include cough, chest pain and shortness of breath. Other non-specific symptoms include headache, night sweats and fever. Of course, the worst case scenario would be meningitis.

Fortunately, this infection is treatable with anti-fungal medications.

Robert Herriman is a microbiologist and the Editor-in-Chief of Outbreak News Today and the Executive Editor of The Global Dispatch

Follow @bactiman63