Fyfe M, MacDougall L, Romney M, Starr M, Pearce M, Mak S, Mithani S, Kibsey P
Vancouver Island Health Authority, Victoria, British Columbia, Canada.
Can Commun Dis Rep. 2008 Jun;34(6):1-12.
Cryptococcus gattii causes disease among immunocompetent individuals in the tropics and subtropics. We document the appearance of C. gattii infections on Vancouver Island (VI), a temperate region, and discuss reasons for this emergence.
Data on Cryptococcus hospitalizations for the calendar years 1995 through 2004 were reviewed. Viable historic isolates stored at the provincial public health laboratory between 1987 and 2000 were serotyped. Human cases were mapped by place of residence.
Cryptococcosis among HIV negative individuals diagnosed on VI increased sharply after 1999. C. gattii was not detected in stored isolates prior to 1999. C. gattii cases lived in a specific biogeoclimatic zone on VI. Higher rates of illness were associated with exposure to the central region of VI.
The emergence of C. gattii in a temperate region is unprecedented. Clinicians should consider C. gattii in the differential diagnosis of individuals who travelled to certain areas in British Columbia.
加氏隐球菌在热带和亚热带地区可导致免疫功能正常的个体发病。我们记录了加氏隐球菌感染在温带地区温哥华岛（VI）的出现情况，并讨论了其出现的原因。
回顾了1995年至2004年历年隐球菌住院治疗的数据。对1987年至2000年保存在省级公共卫生实验室的有活力的历史分离株进行了血清分型。按居住地对人类病例进行了绘图。
1999年后，在VI诊断出的HIV阴性个体中的隐球菌病急剧增加。1999年之前在保存的分离株中未检测到加氏隐球菌。加氏隐球菌病例居住在VI的一个特定生物地理气候区。较高的发病率与接触VI的中部地区有关。
加氏隐球菌在温带地区的出现是前所未有的。临床医生在对前往不列颠哥伦比亚省某些地区的个体进行鉴别诊断时应考虑加氏隐球菌。
