We assume that subclinical primary infections are common and that the vast majority are asymptomatic. Postmortem studies on immunocompetent persons without antecedent respiratory complaints have demonstrated foci of C. neoformans in the lungs and hilar lymph nodes [4,5]. These foci consisted of small areas of granulomatous inflammation either in the lung parenchyma or pulmonary lymph nodes. They are generally smaller than those seen in tuberculosis and do not appear to calcify as often as seen with histoplasmosis.
Thus, the pulmonary lesions of cryptococcosis are usually clinically and radiographically silent. The foci of yeasts can persist in a latent stage and can become liberated from the granulomatous complexes, causing active infection, if the host immune system becomes compromised.