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Follow-up is very important for all patients diagnosed with cryptococcosis. Patients who do not follow up with their medical-care providers leave themselves open to reactivation of the fungal infection, and in some cases, progression to dire outcomes. Follow-up allows the caregivers to adjust medications to fit the ongoing condition of the individual and discover if treatments are effective and if the disease is progressing or, at some point, eliminated. This information allows caregivers to modify treatment protocols to best serve the patient.
The best way to prevent cryptococcosis is to not inhale the fungus. This is difficult to do if you live in areas where the fungus resides, although some researchers say that some masks (ones that filter particles that are as small as 3 micrometers) may help prevent inhalation. One of the main sources of C. neoformans is dried pigeon feces, so avoiding areas that contain it may help prevent the disease. Avoiding dust that contains any type of bird feces may also help prevent infections.
Because C. gattii is spread by plant debris and propagules, it is hard to avoid inhalation if a person is in an area that C. gattii inhabits. Higher concentrations occur in air when trees like eucalyptus and gum trees release propagules, but they are also found in the dust around these trees. However, since these trees are usually found in semitropical and tropical regions, avoiding areas where these trees are producing propagules (flowering) may help prevent the disease. Unfortunately, with C. gattii now occurring in the Pacific Northwest, researchers suggest that C. gattii is adapting to survive in this region. Avoiding dust inhalation, especially in dense forests and around logging operations may help reduce exposure to C. gattii in the Pacific Northwest.
There is no commercially available vaccine to prevent cryptococcosis.
With early diagnosis and treatment, most people with cryptococcosis will have a good or excellent prognosis because the infection will be stopped. Those who are diagnosed late in the infectious process or who are immunosuppressed have a fair to poor prognosis and may have a mortality (death) rate as high as 30%. Those who survive have a relapse or reactivation rate as high as 25% while others often have long-term (years) or lifelong requirements for suppression treatment with antifungal drugs.
The U.S. Centers for Disease Control and Prevention (CDC) considers cryptococcosis, especially when caused by C. gattii, as an emerging infectious disease because of the recent increased occurrence in the Pacific Northwest. Consequently, to prepare for better ways to identify and treat this disease, ongoing research is increasing. To date, there is no vaccine available for humans. However, researchers have developed an experimental vaccine from the fungal carbohydrate capsule that can protect mice from infection, so a vaccine for humans may be developed in the near future. Several laboratories are trying to develop quick, easy, and accurate methods to distinguish the various subtypes of C. neoformans and C. gattii. Other environmental scientists are trying to determine the extent of spread of C. gattii in the U.S. and other countries to determine if environmental changes are influencing (increasing) the areas where Cryptococcus can survive and become endemic. A few researchers are examining the virulence of various strains as some strains (C. gattii, VGllc) may cause more serious infections and deaths than other strains.
Medically Reviewed by a Doctor on 1/4/2016
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