AUTHOR=Goupil de Bouillé Jeanne , Epelboin Loïc , Henaff Fanny , Migaud Mélanie , Abboud Philippe , Blanchet Denis , Aznar Christine , Djossou Felix , Lortholary Olivier , Elenga Narcisse , Puel Anne , Lanternier Fanny , Demar Magalie 

TITLE=Case Report: Invasive Cryptococcosis in French Guiana: Immune and Genetic Investigation in Six Non-HIV Patients

JOURNAL=Frontiers in Immunology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.881352

DOI=10.3389/fimmu.2022.881352

ISSN=1664-3224

ABSTRACT=<sec><title>Objectives</title><p>We describe the clinical, mycological, immunological, and genetic characteristics of six HIV-negative patients presenting with invasive cryptococcosis.</p></sec><sec><title>Methods</title><p>Patients with cryptococcosis without any of the classical risk factors, such as HIV infection, followed at Cayenne Hospital, were prospectively included. An immunologic and genetic assessment was performed.</p></sec><sec><title>Results</title><p>Five male patients and one female patient, 5 adults and one child, were investigated. All presented a neuromeningeal localization. <italic>Cryptococcus neoformans</italic> var. <italic>gattii</italic> and <italic>C. neoformans</italic> var. <italic>grubii</italic> were isolated in two and three patients, respectively, whereas one patient could not be investigated. Overall, we did not observe any global leukocyte defect. Two patients were found with high levels of circulating autoantibodies against Granulocyte macrophage-colony stimulating factor (GM-CSF), and none had detectable levels of autoantibodies against Interferon gamma (IFN-γ) Sequencing of <italic>STAT1</italic> exons and flanking regions performed for four patients was wild type.</p></sec><sec><title>Conclusion</title><p>To better understand cryptococcosis in patients with cryptococcosis but otherwise healthy, further explorations are needed with repeated immune checkups and strain virulence studies.</p></sec>