Effects of diethylstilbestrol and cyclophosphamide on the pathogenesis of experimental Cryptococcus neoformans infections.

Treatment of mice with a single dose of cyclophosphamide 24 h before challenge with Cryptococcus neoformans increased host survival, whereas treatment with 10 daily exposures of cyclophosphamide, starting 2 days before challenge, markedly reduced survival in mice challenged on the second day of drug treatment. Treatment with 14 daily exposures of diethylstilbestrol before challenge with C. neoformans did not markedly affect host survival. A correlation was sought between the distribution of radiolabeled C. neoformans and host survival. Radiolabeled C. neoformans administered intravenously was cleared rapidly from the blood of naive mice and accumulated in the lungs, liver and kidney within 1 h. The radiolabeled yeasts were subsequently cleared from the lungs. The distribution of radiolabeled C. neoformans among organs was generally the same in control mice and mice treated with diethylstilbestrol of various cyclophosphamide regimens after 3 or 24 h. The distribution of C. neoformans measured as colony forming units was generally in agreement with results from radioactivity measurements for animals sacrificed 3 or 24 h after challenge. One week after challenge, C. neoformans colonies were grown from the brain, liver and kidneys. C. neoformans was found in the brain within 1 h after i.v. challenge, suggesting that the central nervous system disease in mice challenged i.v. resulted from a primary infection of the brain.