Cryptococcosis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Cryptococcosis?
Cryptococcosis is an infection caused by breathing in spores of the Cryptococcus fungus. It is treated by an infectious disease doctor, a doctor who treats infections. It usually affects the lungs or the brain. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is cryptococcosis?
Cryptococcosis is an infection caused by breathing in spores from a fungus called Cryptococcus. It usually occurs in the lungs. It can also occur in the brain and spine, where it is called cryptococcal meningitis.
Most infections happen in people with weak immune systems. This is most true for people with advanced HIV disease.
Symptoms
Symptoms depend on the part of the body that is affected.
An infection in the lungs can cause a pneumonia-like illness. Symptoms include:
- Cough, which is the most common symptom.
- Shortness of breath.
- Chest pain.
- Fever.
When the infection reaches the brain, it is called cryptococcal meningitis. Symptoms include:
- Headache and fever.
- Confusion or changes in behavior.
- Neck pain.
- Nausea and vomiting.
- Sensitivity to light.
Some people have fungal growths called cryptococcomas in the lungs, skin, brain, or other organs.
Some people have no symptoms at all. Most of the time these infections go away on their own.
Cryptococcal meningitis may lead to permanent damage to the nerves and brain. It can be fatal, especially without the right treatment.
Causes and who gets it
Two species of Cryptococcus cause most infections. They are C. neoformans and C. gattii. The fungus lives in soil, decaying wood, and tree hollows. C. neoformans also lives in bird droppings.
C. neoformans is found around the world. C. gattii mostly lives in tropical and subtropical areas. It is also found in cooler places such as British Columbia, Oregon, Washington, and California.
Cryptococcal infections cannot spread between people.
The risk is highest in people with weak immune systems. This includes people who:
- Have advanced HIV/AIDS.
- Have had an organ transplant.
- Take medicines that weaken the immune system, such as corticosteroids and medicines for rheumatoid arthritis.
People with a healthy immune system can get infected, but it is less common.
Symptoms often start weeks to months after breathing in the spores. Some people get sick years later if their immune system becomes weak.
How doctors diagnose it
Doctors test samples from the body to find the fungus. A culture is the gold standard test. A culture grows the fungus from a sample so it can be identified.
Another test uses India ink to see the fungus cells under a microscope. This is usually done on cerebrospinal fluid, the fluid around the brain and spine.
An antigen test looks for a substance from the fungus in the spinal fluid or blood.
Treatment
Treatment is with antifungal medicines. The type depends on where the infection is and how severe it is.
Fluconazole is the recommended treatment for mild or moderate lung infections and for infections with no symptoms.
For severe lung or brain infections, doctors prefer to start with amphotericin B and flucytosine. After that, most people take fluconazole for a long time to clear the infection.
Treatment may differ for groups such as children and pregnant women. Some people also need surgery to remove fungal growth.
When to see a doctor
People who may have cryptococcosis should see a healthcare provider right away.
Call 911 or go to the emergency room if you have a seizure, faint, have a major change in mental status such as severe confusion or being hard to wake up, or have severe trouble breathing.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can check your symptoms and order first tests. They can refer you to an infectious disease doctor. They can also help with follow-up care after treatment.
Common questions
Is cryptococcosis contagious?
No, cryptococcosis does not spread between people. People get it by breathing in spores from the environment.
What are the symptoms of cryptococcosis?
It depends on where the infection is. Lung infections can cause cough, shortness of breath, chest pain, and fever. Brain infections can cause headache, fever, confusion, neck pain, and sensitivity to light.
Who is most at risk for cryptococcosis?
People with weak immune systems are most at risk. Examples are people with advanced HIV/AIDS or an organ transplant.
Can cryptococcosis be treated?
Yes, it is treated with antifungal medicines. Which medicine is used depends on where the infection is and how severe it is.
Sources
- CDC - Symptoms of Cryptococcosis
- CDC - Clinical Overview of Cryptococcosis
- CDC - Cryptococcosis: Causes and How It Spreads
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
