Cerebral and pulmonary findings of cryptococcus on computed tomography: pictorial essay of the main imaging findings.

Cryptococcosis is an invasive infection caused by Cryptococcus neoformans, an encapsulated pathogenic fungus found globally in bird excreta, soil, and trees. Inhalation of the organism is the usual route of infection. If the fungal cells survive their initial interaction with alveolar macrophages in the lungs, they migrate to the systemic bloodstream and cross the blood-brain barrier, resulting in a central nervous system (CNS) infection. Cryptococcal infection can occur in individuals with normal immunity but is most common in immunocompromised hosts. Chest tomography typically shows solitary or multiple parenchymal nodules or consolidation with a surrounding area of ground-glass opacity, and cavitation may be observed, particularly in immunocompromised patients. On neuroimaging, the most common findings are leptomeningeal enhancement, followed by perivascular space dilatation with gelatinous pseudocysts. Cryptococcal infection results in significant morbidity and mortality. Imaging plays a critical role in the diagnosis of the illness, monitoring therapy response, and identifying related complications. Early detection can optimize treatment and clinical management.