The Pain is in the Brain with the Sugar-Coated Killer

Abstract Cryptococcus neoformans and C. gattii represent encapsulated yeasts which have become increasingly common central nervous system (CNS) pathogens during the enlarging age of the immunocompromised host. CNS disease represents a major interaction between the host and the yeast. In this regard, we have examined the myriads of tools that this group of yeasts possess that allow them to become very efficient pathogens in the human CNS, causing fatal meningoencephalitis if untreated. In the age of molecular pathogenesis for fungi, cryptococcosis has been studied extensively at the genetic level, and there is an impressive array of virulence factors that this basidiomycetous pathogen has developed to cause disease. This review details a series of virulence factors and their pathways. There is also some appreciation for the complexity of the host responses which are so essential to the outcome of these infections.