[5] In 2007, the fungus appeared for the first time in the United States, in Whatcom County, Washington[6] and in April 2010 had spread to Oregon.

C. gattii occupies an environmental niche in decaying hollows of trees native to tropical as well as subtropical and temperate regions.

Isolates were found associated with Canary Island pine (Pinus canariensis), American sweetgum (Liquidambar styraciflua), and Pohutukawa tree (Metrosideros excelsa).

[10] One study concluded "[j]ust as people who travel to South America are told to be careful about drinking the water, people who visit other areas like California, the Pacific Northwest, and Oregon need to be aware that they are at risk for developing a fungal infection, especially if their immune system is compromised.

[citation needed] In the United States, C. gattii serotype B, subtype VGIIa, is largely responsible for clinical cases.

In 2007, the first case in North Carolina was reported, subtype VGI, which is identical to the isolates found in Australia and California.

[14] VGII C. gattii have probably undergone either bisexual or unisexual reproduction in multiple different locales, thus giving rise to novel virulent phenotypes.

[1] Unlike Cryptococcus neoformans, C. gattii is not particularly associated with human immunodeficiency virus infection or other forms of immunosuppression.

The optimal growth temperature of C. gattii is 30 C.[16] Medical treatment consists of prolonged intravenous therapy (for 6–8 weeks or longer) with the antifungal drug amphotericin B, either in its conventional or lipid formulation.