Evidence of zoonotic transmission Cryptococcus neoformans from a pet cockatoo to an immunocompromised patient

Background: Although cryptococcosis has been associated with birds for almo st 50 years, point sources for infection have not been identified. Objective: To document zoonotic transmission of Cryptococcus neoformans. Design: Case report. Setting: A:home in Boston, Massachusetts. Patient: A:72-year-old woman who received a diagnosis of cryptococcal menin gitis in November 1998, The patient, who had been taking immunosuppressant drugs since undergoing renal transplantation in 1989, owned a pet cockatoo: Measurements: Cryptococcus neoformans was isolated from the feces of the co ckatoo. Isolates from excreta and from the patient were compared by using b iochemical profiles, monoclonal antibody binding patterns, restriction frag ment length polymorphism analysis, and karyotyping. Results: The isolates from the patient and the cockatoo had identical bioch emical profiles, the same monoclonal antibody immunofluorescence patterns, and indistinguishable patterns on restriction fragment length polymorphism analysis and karyotyping. Conclusions: The indistinguishable patient and cockatoo isolates strongly s uggest that the patient's infection resulted from exposure to aerosolized c ockatoo excreta. Although the incidence of cryptococcal infection due to su ch exposure is unknown, it may be prudent to advise immunocompromised patie nts to avoid pet birds and avian excreta.