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In the last 25 years, the cases of human and animal cryptococcosis have increased significantly. This is mostly due to the improvement in the survival of immunocompromised patients. The disease is frequently related to the exposure of this type of patients to avian droppings. Among birds, pigeon, Columba livia, is undoubtedly the most important reservoir for the Cryptococcus species. Nevertheless, the study of a large number of bird's species demonstrated that pigeons are not the only Cryptococcus spp. carriers. The suspicion of the birds being the source for the infection is now becoming a demonstrable fact thanks to the use of molecular typing methods. These methods allow the comparison between strains from birds to patients living around them, with high level of discrimination.

Until recently, Cryptococcus gattii infections occurred mainly in tropical and subtropical climate zones. However, during the past decade, C. gattii infections in humans and animals in Europe have increased. To determine whether the infections in Europe were acquired from an autochthonous source or associated with travel, we used multilocus sequence typing to compare 100 isolates from Europe (57 from 40 human patients, 22 from the environment, and 21 from animals) with 191 isolates from around the world. Of the 57 human patient isolates, 47 (83%) were obtained since 1995. Among the 40 patients, 24 (60%) probably acquired the C. gattii infection outside Europe; the remaining 16 (40%) probably acquired the infection within Europe. Human patient isolates from Mediterranean Europe clustered into a distinct genotype with animal and environmental isolates. These results indicate that reactivation of dormant C. gattii infections can occur many years after the infectious agent was acquired elsewhere. [ABSTRACT FROM AUTHOR]