Evidence of Zoonotic Transmission of Cryptococcus neoformans from a Pet Cockatoo to an Immunocompromised Patient

  1. Joshua D. Nosanchuk, MD;
  2. Shmuel Shoham, MD;
  3. Bettina C. Fries, MD;
  4. Daniel S. Shapiro, MD;
  5. Stuart M. Levitz, MD; and
  6. Arturo Casadevall, MD, PhD
  1. From Albert Einstein College of Medicine, Bronx, New York; and Boston University School of Medicine, Boston, Massachusetts.

    Abstract

    Background: Although cryptococcosis has been associated with birds for almost 50 years, point sources for infection have not been identified.

    Objective: To document zoonotic transmission of Cryptococcus neoformans.

    Design: Case report.

    Setting: A home in Boston, Massachusetts.

    Patient: 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.

    Measurements: 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.

    Results: 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.

    Conclusions: 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.

    Article and Author Information

    • Acknowledgments: The authors thank L. Freundlich for assistance with the API 20C clinical yeast system.

    • Requests for Single Reprints: Arturo Casadevall, MD, PhD, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461; e-mail, casadeva{at}aecom.yu.edu.

    • Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.

    • Current Author Addresses: Drs. Nosanchuk, Fries, and Casadevall: Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461.

    • Drs. Shoham, Shapiro, and Levitz: Boston University School of Medicine, 88 East Newton Street, Boston, MA 02118.

    • Author Contributions: Conception and design: J.D. Nosanchuk, S. Shoham, S.M. Levitz, A. Casadevall.

    • Analysis and interpretation of the data: J.D. Nosanchuk, B.C. Fries, D.S. Shapiro, S.M. Levitz, A. Casadevall.

    • Drafting of the article: J.D. Nosanchuk, S. Shoham, A. Casadevall.

    • Critical revision of the article for important intellectual content: B.C. Fries, S.M. Levitz, D.S. Shapiro.

    • Final approval of the article: J.D. Nosanchuk, B.C. Fries, S. Shoham, D.S. Shapiro, S.M. Levitz, A. Casadevall.

    • Provision of study materials or patients: B.C. Fries, S. Shoham, D.S. Shapiro, S.M. Levitz.

    • Obtaining of funding: J.D. Nosanchuk, B.C. Fries, S.M. Levitz, A. Casadevall.

    • Administrative, technical, or logistic support: D.S. Shapiro, S.M. Levitz, A. Casadevall.

    • Collection and assembly of data: J.D. Nosanchuk, S. Shoham.

    Summary for Patients

    • Summaries for Patients:A Case of Cryptococcal Infection in a Patient with an Abnormal Immune System and a Pet Cockatoo Ann Intern Med February 1, 2000 132:205
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    1. Ann Intern Med February 1, 2000 vol. 132 no. 3 205-208
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