Cryptococcosis

CLINICAL MICROBIOLOGY REVIEWS, Oct. 1995, p. 515–548 0893-8512/95/$04.00 0 Copyright 1995, American Society for Microbiology

Vol. 8, No. 4

Cryptococcosis in the Era of AIDS—100 Years after the Discovery of Cryptococcus neoformans
THOMAS G. MITCHELL1*
AND

JOHN R. PERFECT2

Department of Microbiology1 and Division of Infectious Diseases, Department of Medicine,2 DukeUniversity Medical Center, Durham, North Carolina 27710 INTRODUCTION .......................................................................................................................................................516 CRYPTOCOCCUS NEOFORMANS............................................................................................................................516 Ecology, SexualReproduction, and Identification .............................................................................................517 Growth and Physiology ..........................................................................................................................................518 Virulence Factors....................................................................................................................................................519 Growth and responses in vivo...........................................................................................................................519 CPS.......................................................................................................................................................................519 Phenol oxidase and melanin production .........................................................................................................519 Other determinants of pathogenicity ...............................................................................................................520 Antigenic Composition...........................................................................................................................................520 Serotypes ..............................................................................................................................................................520 GXM.....................................................................................................................................................................520 GalXM and mannoprotein ................................................................................................................................520 Other antigens.....................................................................................................................................................520Molecular Biology ...................................................................................................................................................520 Karyotypes, repetitive elements, and strain-specific probes.........................................................................520 Gene cloning........................................................................................................................................................521 Transformation ...................................................................................................................................................521EPIDEMIOLOGY.......................................................................................................................................................522 Patients with AIDS .................................................................................................................................................522 HOST DEFENSES......................................................................................................................................................522 Pathogenesis...