Nosanchuk J D, Shoham S, Fries B C, Shapiro D S, Levitz S M, Casadevall A
Albert Einstein College of Medicine, Bronx, New York 10461, USA.
Ann Intern Med. 2000 Feb 1;132(3):205-8. doi: 10.7326/0003-4819-132-3-200002010-00006.
Although cryptococcosis has been associated with birds for almost 50 years, point sources for infection have not been identified.
To document zoonotic transmission of Cryptococcus neoformans.
Case report.
A home in Boston, Massachusetts.
A 72-year-old woman who received a diagnosis of cryptococcal meningitis in November 1998. The patient, who had been taking immunosuppressant drugs since undergoing renal transplantation in 1989, owned a pet cockatoo.
Cryptococcus neoformans was isolated from the feces of the cockatoo. Isolates from excreta and from the patient were compared by using biochemical profiles, monoclonal antibody binding patterns, restriction fragment length polymorphism analysis, and karyotyping.
The isolates from the patient and the cockatoo had identical biochemical profiles, the same monoclonal antibody immunofluorescence patterns, and indistinguishable patterns on restriction fragment length polymorphism analysis and karyotyping.
The indistinguishable patient and cockatoo isolates strongly suggest that the patient's infection resulted from exposure to aerosolized cockatoo excreta. Although the incidence of cryptococcal infection due to such exposure is unknown, it may be prudent to advise immunocompromised patients to avoid pet birds and avian excreta.
尽管隐球菌病与鸟类的关联已近50年，但感染的源头尚未明确。
记录新型隐球菌的人畜共患病传播情况。
病例报告。
马萨诸塞州波士顿的一户人家。
一名72岁女性，于1998年11月被诊断为隐球菌性脑膜炎。该患者自1989年接受肾移植后一直在服用免疫抑制药物，她养了一只宠物凤头鹦鹉。
从凤头鹦鹉的粪便中分离出新型隐球菌。通过生化谱、单克隆抗体结合模式、限制性片段长度多态性分析和核型分析对排泄物和患者的分离株进行比较。
患者和凤头鹦鹉的分离株具有相同的生化谱、相同的单克隆抗体免疫荧光模式，在限制性片段长度多态性分析和核型分析中也表现出难以区分的模式。
患者和凤头鹦鹉难以区分的分离株强烈表明，患者的感染是由于接触了雾化的凤头鹦鹉排泄物。尽管因这种接触导致隐球菌感染的发生率尚不清楚，但建议免疫功能低下的患者避免接触宠物鸟和鸟类排泄物可能是谨慎的做法。
