Cryptococcal Meningitis after Unusual Exposures to Birds

To the Editor: Although it is well known that various birds carry cryptococci, the degree of human exposure to birds that is required for the emergence of clinical cryptococcal disease is not known. Two patients with cryptococcal meningitis had unusually intense exposures. The patients were seropositive for the human immunodeficiency virus (HIV) but had been asymptomatic until meningitis developed. The first patient, a 56-year-old man, helped dismantle an aviary, measuring 16 by 12 by 8 feet, that had been unused for about 10 years. The wooden floor of the aviary was rotten, and its removal produced clouds of dust. Demolishing . . .