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SECTION I - INFECTIOUS AGENT
NAME: Cryptococcus neoformans
SYNONYM OR CROSS REFERENCE: Cryptococcosis, Torulosis, European blastomycosis.
CHARACTERISTICS: Yeast; often budding, surrounded by a wide capsule.
SECTION II - HEALTH HAZARD
PATHOGENICITY: Mycosis presenting as a subacute or chronic meningitis; infection of lung, kidney, prostate,
bone or liver may occur; skin lesions, ulcers or subcutaneous tumor-like masses; untreated meningitis terminates
fatally within several months.
EPIDEMIOLOGY: Sporadic cases occur in all parts of the world; males infected twice as frequently as females,
mainly adults; important mycosis in immunocompromised patients (patients with AIDS or severe combined immunodeficiency).
HOST RANGE: Humans; cats, dogs, horses, cows, monkeys and other animals.
INFECTIOUS DOSE: Low level of pathogenicity for normal immunocompetent adults.
MODE OF TRANSMISSION: Presumably by inhalation.
INCUBATION PERIOD: Unknown; pulmonary disease may precede brain infection by months or years.
COMMUNICABILITY: Not transmitted directly from person to person.
SECTION III - DISSEMINATION
RESERVOIR: Saprophytic growth in external environment; isolated consistently from old pigeon nests, pigeon
droppings and from soil in many parts of world.
ZOONOSIS: Not transmitted from animals to humans.
VECTORS: None
SECTION IV - VIABILITY
DRUG SUSCEPTIBILITY: Sensitive to amphotericin B, 5-fluorocytosine, ketoconazole.
SUSCEPTIBILITY TO DISINFECTANTS: Susceptible to 1% sodium hypochlorite (20% commercial bleach), iodine,
phenolics, glutaraldehyde, formaldehyde; susceptibility to 70% ethanol questionable.
PHYSICAL INACTIVATION: Inactivated by moist heat (121o C for at least 15 min.)
SURVIVAL OUTSIDE HOST: Survives for months to years, especially in pigeon droppings.
SECTION V - MEDICAL
SURVEILLANCE: Monitor for symptoms; confirm by microscopic examination of specimens, cryptococcal antigen
and/or culture.
FIRST AID/TREATMENT: Combination therapy with amphotericin B and fluconazole or fluconazole (treatment choice
depends on severity of infection, immunocompetance and presence/absence of meningitis).
IMMUNIZATION: None
PROPHYLAXIS: None
SECTION VI - LABORATORY HAZARDS
LABORATORY-ACQUIRED INFECTIONS: Respiratory infections from lab exposure not recorded; recorded case
as a result of laceration by a scalpel blade contaminated with encapsulated yeast cells.
SOURCES/SPECIMENS: Clinical specimens and tissues (blood, CSF); soil, pigeon droppings and other environmental
sources.
PRIMARY HAZARDS: Accidental parenteral inoculation of cultures or other infectious materials; bites by experimentally
infectious mice;, manipulations of infectious environmental materials (pigeon droppings) also represent a potential
hazard.
SPECIAL HAZARDS: Immunocompromised individuals are particularly at risk.
SECTION VII - RECOMMENDED PRECAUTIONS
CONTAINMENT REQUIREMENTS: Biosafety level 2 practices, containment equipment and facilities are recommended
for activities with known or potentially infectious materials; processing of soil or other environmental materials
likely to contain infectious yeast cells should be conducted in a biological safety cabinet.
PROTECTIVE CLOTHING: Laboratory coat; gloves when direct contact with infectious materials is unavoidable.
OTHER PRECAUTIONS: Good sanitation, cleaning and disinfection important.
SECTION VIII - HANDLING INFORMATION
SPILLS: Allow aerosols to settle; wearing protective clothing, gently cover spill with paper towels and
apply 1% sodium hypochlorite (20% commercial bleach), starting at perimeter and working towards the center; allow
sufficient contact time (30 min.) before clean up.
DISPOSAL: Decontaminate before disposal; steam sterilization, incineration, chemical disinfection.-
STORAGE: In sealed containers that are appropriately labeled.
Date prepared: October 11, 1997 Prepared by: Canadian Office of Biosafety Information edited by the Colorado State
University Office of Biosafety- June 16, 1998.
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