Subacute or chronic meningitis is the most common clinical manifestation of disseminated cryptococcal infection. The clinical presentation is variable and prognostic. Overt symptoms of meningitis and HIV infection are predictors of a poor outcome. Postinfectious sequelae are common and include hydrocephalus, changes in visual acuity, deafness, cranial nerve palsies, seizures, and ataxia. Sepsis syndrome is a rare manifestation of cryptococcosis and occurs almost exclusively in HIV-infected patients.
Fever is followed by respiratory distress and multiorgan system disease.
This syndrome is often fatal. Cutaneous disease may accompany disseminated cryptococcosis or local infection. Early lesions are erythematous, may be single or multiple, and are variably indurated and tender. Lesions often become ulcerated with central necrosis and raised borders. Cutaneous cryptococcosis in HIV-infected patients may resemble molluscum contagiosum.