Cryptococcal meningitis

Historical note and nomenclature
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By Joseph R Berger MD

Human cryptococcal infection was first described during the last decade of the 19th century. Busse, a pathologist, and Buschke, a surgeon, separately reported the isolation of yeast from the tibia of a young woman (Busse 1894; Buschke 1895). In 1905 the yeast was identified as a CNS pathogen when von Hansemann described the first case of cryptococcal meningitis (Hansemann 1905).

Several different terms have been applied to the fungus currently referred to as Cryptococcus neoformans. Familiarity with these terms is helpful in reading the older literature. Busse employed the term “Saccharomyces hominis” because of the sarcoma-like appearance of the patient’s lesions (Busse 1894). The fungus was transferred to the genus Cryptococcus by Vuillemin because of the absence of ascospores (Vuillemin 1901). Subsequently, the term “neoformans” was included to indicate “cancer or tumor-causing” in light of an association between the isolation of the organism and cancers. In 1916 Stoddard and Cutler distinguished between cryptococcus, blastomyces, and other mycoses (Stoddard and Cutler 1916). They named Cryptococcus “Torula histolytica” because of the mistaken belief that the cysts observed in tissues were the consequence of digestive actions of the organism. However, this term is no longer in use.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited