C. gattii infection in Man, Japan, 2007 | CDC EID

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Volume 16, Number 7–July 2010
Dispatch
Cryptococcus gattii Genotype VGIIa Infection in Man, Japan, 2007
Koh Okamoto, Shuji Hatakeyama, Satoru Itoyama, Yoko Nukui, Yusuke Yoshino, Takatoshi Kitazawa, Hiroshi Yotsuyanagi, Reiko Ikeda, Takashi Sugita, and Kazuhiko Koike
Author affiliations: University of Tokyo Hospital, Tokyo, Japan (K. Okamoto, S. Hatakeyama, S. Itoyama, Y. Nukui, Y. Yoshino, T. Kitazawa, H. Yotsuyanagi, K. Koike); and Meiji Pharmaceutical University, Tokyo (R. Ikeda, T. Sugita)

Suggested citation for this article

Abstract
We report a patient in Japan infected with Cryptococcus gattii genotype VGIIa who had no recent history of travel to disease-endemic areas. This strain was identical to the Vancouver Island outbreak strain R265. Our results suggest that this virulent strain has spread to regions outside North America.
Cryptococcus neoformans and C. gattii are closely related species of yeast; C. gattii was previously classified as C. neoformans var. gattii (1). Although both species cause pulmonary or central nervous system infections, they differ in their ecology, epidemiology, and pathobiology. C. neoformans is the most common Cryptococcus spp. worldwide and mainly affects immunocompromised hosts. In contrast, C. gattii mainly affects immunocompetent hosts and often forms mass-like lesions (cryptococcomas).

Multilocus sequence typing can be used to divide this species into 4 molecular genotypes, VGI–VGIV, which differ in epidemiology and virulence (1,2). C. gattii was believed to be restricted to tropical and subtropical areas such as Australia, Southeast Asia, and South America (1). However, in 1999, a C. gattii infection outbreak occurred on Vancouver Island, British Columbia, Canada (3), which has a temperate climate.

During the Vancouver Island outbreak, most human, animal, and environmental isolates obtained belonged to VGIIa (major genotype, 90%–95% of isolates) and VGIIb (minor genotype, 5%–10% of isolates) (2,3). These strains have now spread to mainland British Columbia and the Pacific Northwest region of the United States (1,4,5). The potential for further spread of this strain, particularly the VGIIa genotype, is a serious concern because it is highly virulent in mammals and can infect immunocompetent persons (2).

We report a case of cerebral cryptococcoma caused by C. gattii VGIIa (a strain identical to the Vancouver Island outbreak major genotype strain R265) in a patient from Japan who had no recent travel history to known disease-endemic areas.

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Suggested Citation for this Article
Okamoto K, Hatakeyama S, Itoyama S, Nukui Y, Yoshino Y, Kitazawa T, et al. Cryptococcus gattii genotype VGIIa infection in man, Japan, 2007. Emerg Infect Dis [serial on the Internet]. 2010 Jul [date cited].
http://www.cdc.gov/EID/content/16/7/1155.htm

DOI: 10.3201/eid1607.100106