Int J Med Health Sci. Jan 2014,Vol-3;Issue-1 88 International Journal of Medical and Health Sciences Journal Home Page: http://www.ijmhs.net ISSN:2277-4505 Disseminated Cryptococcosis In An Immunocompetent Patient In Northeast India Caused By Serotype B -A Case Report Purnima Barua 1 , Sanjeeb Kakati 2 , Utpala Devi 3 , Ngulani K.S 4 , Jagadish Mahanta 5 * 1 Department of Microbiology, Jorhat MedicalCollege, Assam, India, 2&4 Department of Medicine, Assam Medical College and Hospital, Dibrugarh, 3 Regional Medical Research Centre (Indian Council of Medical Research),Post Box-105, Dibrugarh-786001, India, 5 Regional Medical Research Centre (Indian Council of Medical Research), Post Box-105, Dibrugarh-786001, India. ABSTRACT Disseminated cryptococcosis is not common in immunocompetent persons. Here we report a case of disseminated cryptococcosis in an immunocompetent individual caused by Serotype B. Detailed case history with informed consent was taken followed by thorough investigation. A search was made on the Internet (Medline, ProQuest and Google) for similar findings. Cryptococcus gattii was isolated from blood, CSF and sputum in this case who presented with cough, meningitis, hemiparesis, transient loss of consciousness and sixth nerve palsy at one time. This case of disseminated Cryptococcosis with multiple neurological symptoms caused by Serotype B in an immunocompetent individual is reported due to its rarity. KEYWORDS: Cryptococcus gattii, Immunocompetent, disseminated, sixth nerve palsy, transient loss of consciousness, pulmonary. INTRODUCTION C. neoformans is an encapsulated yeast which causes infections of the central nervous system typically in immunocompromised patients. The clinical manifestations of CNS involvement of cryptococcosis are highly variable, depending not only on the patient’s risk factors, but also on the yeast variety involved [1]. There are two recognized varieties of C.neoformans: C. neoformans var. neoformans (serotypes A and D) with worldwide distribution, isolated from soil contaminated with mammalian and avian (especially pigeon) feces; and C neoformans var. gattii. The former predominantly infects HIV-infected and other immunocompromised patients. Based on capsular differences, Serotype A has been proposed to be separated from C. neoformans var. neoformans into a new distinct variety called C.neoformans var. grubii. Cryptococcus neoformans var. gattii (serotypes B and C) arises mainly in temperate and tropical climates, is found in the soil near eucalyptus trees, and infects immunocompetent patients [2] . C. neoformans var. gattii is believed to behave more aggressively than C. neoformans var. neoforman [3]. The principal sites of cryptococcal infection are pulmonary, CNS and disseminated disease. Disseminated cryptococcosis is defined as recovery of Cryptococcosis neoformans from blood, sterile body fluids or tissues other than pulmonary tissue [4]. Methods: History of the patient was taken along with informed consent of the patient followed by extensive investigations. A thorough search was also made on the Internet (Medline, ProQuest and Google) for similar articles. CASE REPORT A 38 years old lady hailing from Nagaland presented to the Out Patient Department of Medicine, Assam Medical College Hospital in December 2008 with transient loss of consciousness and diplopia for three days. She gave history of cough, severe headache, vomiting of one month and partial seizure for 1 week. She had fever with chill and rigor two months back and was treated empirically for malaria and typhoid fever in her hometown as outpatient and later admitted to a local hospital for investigation. She developed neck stiffness and had Case Report