A 34-year-old white homeless man in New York city is brought in by the police to the emergency room because he was found wandering the streets confused with a staggering gait. On physical exam he is noted to have acne like lesions over a large part of his body accompanied with skin ulcers. He is febrile and has some cranial nerve deficits. A short time later the man becomes short of breath, which was determined to be caused by severe cerebral edema compressing the medulla. Which of the following is the most likely causative agent? (AIPG 2011)
a. The symptoms described including acne-like lesions, skin ulcers, fever, confusion, staggering gait and cranial nerve deficits are a classic example of Cryptococcus neoformans infection.
b. In some patients the cerebral edema progresses to a fatal stage compressing the medulla reducing respiratory efforts. The other yeast listed do not cause cerebral edema.