Molecular Microbiology Research 2015, Vol.5, No.4, 1-3
1
A Letter Open Access
Primary Cutaneous mycosis in an Immunocompetent Parrot Keeper Due to
Cryptococcus neoformans
Dave P.
1
, Pal M.
2,
1. Department of Skin, Welfare Hospital and Research Center, Bharauch-392001, Gujarat, India
2. Department of Microbiology, Immunology and Public Health, College of Veterinary Medicine and Agriculture, P.B.No.34, Debre Zeit, Ethiopia
Corresponding author email: Email
Molecular Microbiology Research, 2015, Vol.5, No.4 doi: 10.5376/mmr.2015.05.0004
Received: 13 Jul., 2015
Accepted: 10 Aug., 2015
Published: 29 Sep., 2015
Copyright
©
2015 Dave P. and Pal M., This is an open access article published under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Preferred citation for this article:
Dave P. and Pal M., 2015, Primary Cutaneous mycosis in an Immunocompetent Parrot Keeper Due to Cryptococcus neoformans, Molecular Microbiology
Research, Vol.5, No.4 1
-
3 (doi
Abstract
The prime objective of this paper is to delineate the etiologic significance of
Cryptococcus
neoformans
in primary
cutaneous mycosis of a 34- year- old male immunocompetent person, who was occupationally exposed to the excreta of a caged
parrot. The biopsy obtained from the cutaneous lesion of a parrot keeper was examined in Indian ink mount, and was cultured onto
the plates of Pal’s sunflower seed medium. In addition, the urine and blood of patient was also inoculated on Pal’s sunflower seed
medium to rule out the systemic infection. In order to establish the source of infection, samples of parrot droppings, and wooden box
were examined on Pal’s sunflower seed medium. Microscopic examination of clinical specimen in India ink preparation revealed
circular, wide, thickly encapsulated yeast cells of
Cryptococcus neoformans
. Numerous dark brown colored colonies of
C.
neoformans
grew from biopsied tissue on Pal’s sunflower seed medium. The microscopic morphology of the fungal isolates was done
in Narayan stain. There was no growth of
C. neoformans
from blood, and urine of the patient on Pal’s sunflower seed medium. The
pathogen was easily recovered from the parrot droppings, and wooden box on Pal’s sunflower medium. These findings conclusively
established that the patient acquired primary cutaneous cryptococcosis from his immediate environment as revealed by the presence
of
C. neoformans
in the excreta, and wooden cage of the caged parrot.
Keywords
Cryptococcus neoformans
; Cutaneous mycosis; Immunocompetent; Narayan stain; Parrot keeper; Pal medium
Introduction
Cutaneous mycosis is a disease of diverse fungal
etiologies with cosmopolitan in distribution (Pal, 2007;
Dave et al., 2015). The disease occurs in both sexes,
and all age groups; and mostly in sporadic form, and
causing significant morbidity (Pal, 2007).The infection
may be primary in origin or secondary to haematogenous
dissemination (Pal, 2007). Among several fungal
cutaneous mycoses, cryptococcosis is one of the
important diseases, and is reported from many
countries of the world (Kamalam et al., 1977; Hay,
1985; Christianson et al., 2003; Joshi et al., 2004;
Bauza et al.,2005; Chang et al., 2009; Kulkarni et al.,
2012; Spiliopoulou et al., 2012). The disease is caused
by the genus
Cryptococcus
, consisting of 37 species of
which
C. neoformans
and
C. gattii
are more pathogenic,
and are implicated in most cases of cryptococcosis (Pal,
2014).
Cryptococcus
is a eukaryotic, Gram positive,
aerobic, non-motile fungus, which occurs as
saprophytes in a wide variety of environmental materials,
and the avian droppings, especially the pigeon excreta
is recognized as the most important saprobic reservoir
for
C. neoformans
(Pal,1997; Pal,2005; Pal et al.,
2014 ; Pal,2015). Globally,
C. neoformans
and
C. gattii
affect approximately 1000,000 individuals annually with
over 620,000 fatalities, and accounts for about one
third of all HIV/AIDS associated deaths, surpassing
tuberculosis mortality in Africa (Park et al., 2009). The
cutaneous cryptococcosis is primarily caused by
C.neoformans
, however, rare cases due to
C. laurentii
and
C. gattii
have also recorded (Kamalam et al., 1977;
Baes and Van Cutsem, 1985; Perfect and Casadevell,
2002; Revenga
et al., 2002; Kulkarni et al., 2012). The
skin lesions occur on any part of the body such as face,
neck, arms, trunk, leg, etc., and may be solitary or
multiple, and painful or painless. Clinical manifestations
of cutaneous cryptococcosis show papules, nodules,
cellulitis, acniform lesions, subcutaneous abscesses,
plaques, and non-healing ulcers (Hay, 1985; Bauza et
al., 2005; Pal, 2007).The scarcity of information on
cutaneous cryptococcosis from this region of India
prompted us to put on record a case of primary
