Cryptococcosis: Symptoms, Causes, Diagnosis, and Treatment Options

Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026

Quick Answer

Cryptococcosis is an illness caused by Cryptococcus fungi, most commonly infecting the lungs or brain, especially in people with weakened immune systems [1]. Symptoms resemble pneumonia or meningitis [1]. It is diagnosed with blood, cerebrospinal fluid and sputum tests plus imaging [1], and treated with antifungal medications over weeks or months [1]. It is not contagious but can cause serious complications like vision loss [1].

What the research says

• HIV-associated cryptococcal meningitis is a major global cause of death. A modeling analysis estimated about 223,100 new cases of cryptococcal meningitis worldwide in 2014, with sub-Saharan Africa accounting for 73% of them. It estimated roughly 181,100 deaths a year, around 15% of AIDS-related deaths, and called the disease a marker of HIV program failure (PubMed: Rajasingham et al., Lancet Infect Dis, 2017 [3]).

• Faster testing and a three-part treatment goal. A 2021 review notes that point-of-care blood tests have allowed quicker diagnosis and screening programs in resource-limited settings. Treatment aims to reduce the fungal burden, control pressure inside the skull, and improve the immune system. Despite advances, incidence and mortality remain unacceptably high where resources are limited (PubMed: Gushiken et al., Infect Dis Clin North Am, 2021 [5]).

• Treatment options are still narrow. A 2020 review points out that drug treatment is limited to amphotericin B, fluconazole, and flucytosine. Toxicity, resistance, and difficulty crossing the blood-brain barrier complicate care, which is why new drugs and delivery methods are being studied (PubMed: Spadari et al., Microorganisms, 2020 [4]).

What Is Cryptococcosis?

Cryptococcosis is an illness caused by infection with Cryptococcus fungi in your brain or lungs. It can also spread to many areas of your body, which is called disseminated cryptococcosis [1].

The fungus behaves differently depending on where it settles. A Cryptococcus infection in your brain is called cryptococcal meningitis. It can cause fever, headaches, and neck stiffness [1]. When it infects your lungs, it is sometimes called cryptococcal pneumonia or pulmonary cryptococcosis [1]. It can cause you to cough and feel like you cannot breathe deeply enough or catch your breath.

Different types of Cryptococcus fungi make different people sick [1]. Cryptococcus neoformans usually only causes people with weakened immune systems to get sick. Cryptococcus gattii can make you sick even if you have a healthy immune system.

Figure 1: Cryptococcosis overview: what it is, where the fungus lives, who is at highest risk, and key facts.

Key Facts About Cryptococcosis

Fact	Detail
What it is	A fungal infection of the lungs, brain, or other body parts [1]
Cause	Cryptococcus neoformans or Cryptococcus gattii fungi [1]
Where the fungus lives	Soil, trees, and bird droppings in many parts of the world [1]
How you get it	Breathing in the fungus from the air [1]
Is it contagious?	No. You cannot catch it from another person [1]
Highest-risk groups	People with HIV/AIDS, certain cancers, transplant recipients, long-term corticosteroid users [1]
Treatment	Antifungal medications for weeks to months [1]
North America mortality (treated)	Estimated at 20% [1]

The Two Fungi Behind the Disease

Feature	Cryptococcus neoformans (C. neoformans)	Cryptococcus gattii (C. gattii)
Who it sickens	Usually only people with weakened immune systems [1]	People with healthy and compromised immune systems [1]
Where it is more common	Many parts of the world	Australia, British Columbia (Canada), U.S. Pacific Northwest, Southeast Asia [1]
Typical setting	Widely distributed globally	Specific regions listed above

What are the symptoms of cryptococcosis?

Symptoms of cryptococcosis depend on where the fungus infects you. Lung infections can cause pneumonia-like symptoms (see our pneumonia guide), and infections of the central nervous system (brain and spinal cord) can cause meningitis-like symptoms. Disseminated cryptococcosis causes symptoms in many parts of your body [1].

Figure 2: Cryptococcosis symptoms by body area: lungs, brain and spinal cord, and skin in disseminated disease.

Lung Symptoms (Cryptococcal Pneumonia)

Symptom	Description
Cough [1]	Persistent coughing, similar to pneumonia
Shortness of breath [1]	Feeling like you cannot catch your breath
Chest pain [1]	Pain or pressure in the chest
Fever [1]	Elevated body temperature

Central Nervous System Symptoms (Cryptococcal Meningitis)

Symptom	Description
Fever [1]	Elevated body temperature
Headache [1]	Persistent head pain
Neck pain or stiffness [1]	You might not be able to touch your chin to your chest
Nausea [1]	Queasy feeling or upset stomach
Vomiting [1]	Throwing up
Sensitivity to light [1]	Discomfort in bright light

Disseminated Cryptococcosis Symptoms

If you have disseminated cryptococcosis, you might have lung or central nervous system symptoms as well as skin changes [1].

Skin change	Description
Thick or hard patches (plaques)	Raised, hardened areas on the skin
Rashes	Red or irritated skin
Sores	Open or ulcerated areas
Bumps	Raised lumps on the skin
Blisters	Fluid-filled bumps

What Causes Cryptococcosis?

The fungi Cryptococcus gattii and Cryptococcus neoformans cause cryptococcosis. They live in the environment, in dirt (soil), on trees, and in bird droppings [1]. Both are found in many parts of the world [1]. C. gattii is more commonly found in Australia, British Columbia (Canada), the U.S. Pacific Northwest, and Southeast Asia.

How Do You Get Cryptococcosis?

You get cryptococcosis from breathing in Cryptococcus fungi from the air [1]. You cannot see it, and it is hard to avoid if you are in an area where it is common [1]. Most people breathe in the fungus without having symptoms [1]. But in some people, the fungus grows in their lungs or travels through their body to their brain, making them sick. Sometimes you can have the fungus in your lungs for a long time, but it only grows and causes symptoms when something, like an illness or medications, weakens your immune system [1].

Is it contagious? No, cryptococcosis is not contagious. You cannot get it from another person who is infected [1].

Who Is More Likely to Get Cryptococcosis?

C. neoformans is more likely to cause disease in people who have a weakened (compromised) immune system. C. gattii can make both people with healthy immune systems and people with compromised immune systems sick.

Risk factor	Why it increases risk
HIV/AIDS [1]	Weakens the immune system
Certain cancers (lymphomas, leukemias) [1]	Cancer and its treatments compromise immunity
Stem cell, organ, or bone marrow transplant [1]	Transplant medications suppress immunity
Long-term high-dose corticosteroid use [1]	Needed for certain chronic lung conditions and autoimmune disorders [1]

Complications of Cryptococcosis

Cryptococcosis can cause serious complications, especially if you have an infection in your brain [1].

Complication	Description
Increased intracranial pressure	Excessive pressure from too much fluid; can cause brain damage if left untreated [1]
Partial or complete blindness [1]	Vision loss from the infection
Eye disease or inflammation [1]	Inflammation affecting the eyes
Extraocular muscle paresis	Weakness in the muscles that control your eyes [1]
Relapse	Symptoms sometimes come back after treatment [1]
IRIS (immune reconstitution inflammatory syndrome)	Immune system overreacts after treatment, making symptoms worse; more common in people with HIV [1]

How Is Cryptococcosis Diagnosed?

Providers diagnose cryptococcosis by testing your tissues or body fluids for signs of Cryptococcus fungi. They may test your blood, cerebrospinal fluid (CSF), and sputum (mucus coughed up from your lungs) [1]. They will also use your symptoms, medical and travel history, and imaging to help diagnose cryptococcosis. Depending on your symptoms, you may get chest X-rays, a CT scan, or an MRI to look for changes in your lungs or brain [1].

Diagnostic tool	What it checks
Blood test	Signs of Cryptococcus fungi in the bloodstream
Cerebrospinal fluid (CSF) analysis	Fungal signs via lumbar puncture (spinal tap) [1]
Sputum test	Fungi in mucus coughed up from the lungs
Chest X-ray	Changes in the lungs
CT scan	Detailed images of lungs or brain
MRI	Detailed brain or lung imaging
Symptoms plus medical and travel history	Helps link exposure to regions where C. gattii is common

How is cryptococcosis treated?

Providers use antifungals to treat cryptococcosis [1]. Your specific treatment depends on where Cryptococcus is in your body and the health of your immune system [1]. For instance, just one antifungal may be enough treatment for people with mild pulmonary cryptococcosis. But people who are severely ill or have cryptococcal meningitis might need more intense treatment, like multiple antifungal medications over a long period of time [1].

Figure 3: Cryptococcosis treatment: antifungal medications, surgery, and procedures that relieve brain pressure.

Specific Medications and Procedures

Treatment	What it is
Fluconazole [1] [4]	An antifungal medication
Amphotericin B (AmB) [1] [4]	A potent antifungal
Flucytosine [1] [4]	An antifungal used in combination therapy
Corticosteroids [1]	Used only in specific situations, such as severe IRIS; not routine for cryptococcal meningitis
Surgery	Removes large masses of fungus (cryptococcomas) [1]
Therapeutic lumbar puncture or shunts	Special tubes that relieve pressure on your brain [1]

What Can You Expect During Treatment?

Depending on where you are infected and how severely sick you are, your provider may need to treat you with antifungal medications for weeks or months to get rid of cryptococcosis [1]. If you have HIV, your provider may need to adjust your antiretroviral treatments [1]. If you have another condition that weakens your immune system, treating the underlying condition may help you fight off cryptococcosis [1].

Can cryptococcosis be cured? Antifungal treatments usually cure people with healthy immune systems [1]. People with compromised immune systems can be harder to cure [1]. Sometimes, your symptoms can come back after treatment [1].

What Is the Mortality Rate for Cryptococcosis?

Mortality (death) rates for treated cryptococcosis in North America (including the U.S. and Canada) are estimated at 20% [1]. But in parts of Africa, it is estimated to be as high as 70% [1]. What area of the world you live in greatly impacts the healthcare that is available to you [1]. People in economically disadvantaged parts of the world often have higher mortality rates for many diseases.

Can Cryptococcosis Be Prevented?

Cryptococcosis can be hard to prevent where Cryptococcus is common, but providers may recommend precautions for people at higher risk of getting sick. If you are at a higher risk for getting sick from Cryptococcus, your provider may recommend the following.

Prevention strategy	How it works
Targeted screening	Before beginning HIV treatment, a provider can test you for Cryptococcus antigens (recognizable parts of the fungus), even without symptoms [1] [5]. If positive, they can treat you to prevent illness from fungus already in your body [1].
Prophylaxis	If you are high-risk, your provider can treat you with antifungal medication to help prevent illness if you are exposed to Cryptococcus [1].

How can people live well with cryptococcosis?

The best way to take care of yourself is to treat any conditions you have that might weaken your immune system. Keep up with scheduled appointments with your healthcare providers. Ask them about ways to identify signs or symptoms of infection, how to prevent infections, and what you should do if you think you have one. For general background on this group of infections, see our guide to fungal infections (mycosis).

When should I see my healthcare provider? If you have a condition that weakens your immune system, such as HIV, ask your provider how you can prevent illness. See a provider right away if you have a weakened immune system and you have symptoms of cryptococcosis or any other infection.

When Should I Go to the ER?

Go to the emergency room if you have symptoms of a severe illness, including the following.

Emergency sign	Why it matters
High fever (over 103°F / 39.4°C) [1]	Sign of severe infection
Difficulty breathing [1]	Lung involvement may be worsening
Vision changes [1]	Possible eye or brain involvement
Chest pain [1]	Could signal serious lung infection
Bluish skin, lips, or nails [1]	Poor oxygenation
Confusion [1]	Possible brain involvement
Seizures [1]	Sign of neurological emergency

If you have a weakened immune system, ask your provider what symptoms should prompt you to go to the ER. You may need emergency care right away or with less severe symptoms than what is listed above [1].

Questions to Ask Your Doctor

Question	Why ask it
How serious is this infection?	Helps you understand your prognosis
How do I take my medication?	Ensures correct dosing
For how long do I need to be treated?	Treatment can last weeks or months
What can I do to prevent an infection in the future?	Helps you plan ahead

Conclusion

Cryptococcosis is a fungal infection of the lungs or brain caused by Cryptococcus neoformans or Cryptococcus gattii, both found in soil, trees, and bird droppings worldwide. It is not contagious; you get it by inhaling the fungus from the air. While most people breathe it in without symptoms, those with weakened immune systems (from HIV/AIDS, cancer, transplants, or long-term corticosteroids) face the highest risk of serious illness. Treatment involves antifungal medications for weeks or months, and in some cases surgery or procedures to relieve brain pressure.

If you have a weakened immune system and develop pneumonia-like or meningitis-like symptoms, especially after spending time in areas where C. gattii is common, contact a healthcare provider promptly for testing. Early diagnosis with blood, CSF, or sputum analysis can prevent serious complications like vision loss and brain damage. Ask your provider about screening and preventive antifungals if you are at high risk.

Frequently Asked Questions

1. What is cryptococcosis?

Cryptococcosis is an illness caused by infection with Cryptococcus fungi in your brain or lungs. It can also spread to many areas of your body, called disseminated cryptococcosis. Brain infection is called cryptococcal meningitis; lung infection is called cryptococcal pneumonia.

2. What causes cryptococcosis?

The fungi Cryptococcus gattii and Cryptococcus neoformans cause cryptococcosis. They live in the environment (in soil, on trees, and in bird droppings) and are found in many parts of the world.

3. How do you get cryptococcosis?

You get cryptococcosis by breathing in Cryptococcus fungi from the air. You cannot see the fungus, and it is hard to avoid in areas where it is common. Most people breathe it in without symptoms, but in some it grows in the lungs or travels to the brain.

4. Is cryptococcosis contagious?

No. Cryptococcosis is not contagious. You cannot get it from another person who is infected.

5. Who is at highest risk for cryptococcosis?

People with weakened immune systems are at higher risk from C. neoformans, including those with HIV/AIDS, certain cancers (lymphomas, leukemias), stem cell, organ, or bone marrow transplant recipients, and people on long-term high-dose corticosteroids. C. gattii can sicken people with healthy immune systems too.

6. What are the symptoms of cryptococcosis?

Symptoms depend on the infection site. Lung symptoms include cough, shortness of breath, chest pain, and fever. Brain and spinal cord symptoms include fever, headache, stiff neck, nausea, vomiting, and light sensitivity. Disseminated disease can also cause skin plaques, rashes, sores, bumps, and blisters.

7. How is cryptococcosis diagnosed?

Providers diagnose it by testing blood, cerebrospinal fluid (CSF), and sputum for signs of Cryptococcus fungi. They also use symptoms, medical and travel history, and imaging such as chest X-rays, CT scans, or MRIs.

8. How is cryptococcosis treated?

Providers use antifungal medications such as fluconazole, amphotericin B, and flucytosine. Mild lung cases may need just one antifungal, while severe cases or cryptococcal meningitis require multiple antifungals over a long period. Surgery or therapeutic lumbar puncture or shunts may relieve brain pressure.

9. Can cryptococcosis be cured?

Antifungal treatments usually cure people with healthy immune systems. People with compromised immune systems can be harder to cure, and symptoms can sometimes return after treatment.

10. Can cryptococcosis be prevented?

It is hard to avoid breathing in Cryptococcus in areas where it is common. High-risk people may benefit from targeted antigen screening before starting HIV treatment and prophylactic antifungal medication to prevent illness if exposed.

11. What is the mortality rate for cryptococcosis?

Mortality for treated cryptococcosis in North America is estimated at 20%. In parts of Africa, it is estimated to be as high as 70%, reflecting differences in healthcare access worldwide.

Related Reading

Learn more in our guide to HIV Viral Load: Test, Normal Range, Results and What They Mean.

References

1. Cleveland Clinic. Cryptococcosis. Cleveland Clinic. May 30, 2023. https://my.clevelandclinic.org/health/diseases/25040-cryptococcosis

2. Casadevall A. Chapter 215: Cryptococcosis. In: Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson JL, eds. Harrison's Principles of Internal Medicine. 21st ed. McGraw Hill; 2022. https://accessmedicine.mhmedical.com/content.aspx?sectionid=265435208&bookid=3095

3. Rajasingham R, Smith RM, Park BJ, et al. Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis. Lancet Infect Dis. 2017;17(8):873-881. doi:10.1016/S1473-3099(17)30243-8. PMID: 28483415.

4. Spadari CC, Wirth F, Lopes LB, Ishida K. New approaches for cryptococcosis treatment. Microorganisms. 2020;8(4):613. doi:10.3390/microorganisms8040613. PMID: 32340403.

5. Gushiken AC, Saharia KK, Baddley JW. Cryptococcosis. Infect Dis Clin North Am. 2021;35(2):493-514. doi:10.1016/j.idc.2021.03.012. PMID: 34016288.

Medical Disclaimer

This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here.