February 8, 2000
Pet Bird Is Suspect in Death of Patient
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By DENISE GRADY
or months, the 72-year-old woman had not been herself. Her mind seemed
to have dulled, and her mood had turned
flat. Doctors at one hospital diagnosed
But when she became feverish and
confused, her family took her to another
Rebecca Cooney for The New York Times
Cockatoos, and many other kinds of birds, may spread a fungus to people.
Doctors there, at the Boston
University School of Medicine, discovered that she had meningitis, an infection of the membranes enclosing the
brain and spinal cord. She had probably
been infected for months.
Tests showed that the cause of her
illness was a fungus, Cryptococcus neoformans, that rarely makes healthy
people sick. But it is a major threat to
people with weak immune systems.The
patient, who had received a kidney
transplant in 1989, was vulnerable because she was taking antirejection
drugs that suppressed her immunity.
Doctors wondered how she had been
exposed. Cryptococcus is found in soil,
and researchers have known for nearly
50 years that it is also teeming in the
droppings of many birds, including canaries, pigeons, parakeets and parrots.
A teaspoon of droppings can harbor as
many as 300 million organisms. The fungus does not make the birds sick, but
birds have long been suspected of transmitting it to people through droppings,
which can be stirred into a cloud of particles and inhaled. But no case of cryptococcal disease has ever been proved to
have come from droppings.
Dr. Shmuel Shoham, who is training
at Boston University, learned from the
patient that she lived with her daughter,
son-in-law, their children -- and their
pet cockatoo. Dr. Shoham's mentor, Dr.
Stuart Levitz, then recommended that
the bird's droppings be tested.
|People with weakened immune systems are cautioned about birds.|
The patient's son-in-law hated the
cockatoo and was only too happy to collect evidence, Dr. Shoham said.
Dr. Levitz then turned the droppings
over to Dr. Arturo Casadevall, an expertin growing cryptococcus from bird excreta and in molecular typing."
At his laboratory, at the Albert Einstein College of Medicine in the Bronx,
scientists performed genetic tests to
compare the fungus from the droppings
with the fungus from the patient's spinal fluid. "They were indistinguishable," Dr. Casadevall said.
The findings, published this month in
Annals of Internal Medicine, are the
first in which cryptococcus from a sick
patient has been genetically matched to
that from a bird.
"A person could legitimately say it's
possible there was a third source," Dr.
Levitz said, "and both the patient and
the bird got exposed, but I think for all
practical purposes she got it from the
Although drugs apparently worked
against the infection, the illness touched
off other problems, culminating in pneumonia. The patient died 39 days after
the fungus was identified.
The case does not mean that most
people should get rid of birds or other
pets, Dr. Levitz said.
"But people with impaired immune
systems, transplant recipients or AIDS
or lymphoma patients, they're very susceptible," Dr. Levitz said. "They should