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Cryptococcus neoformans is an important cause of morbidity in HIV-infected patients worldwide. In the northern region of Brazil, the prevalence of this infection is poorly known due to a lack of systematic investigations. This study aimed to determine the occurrence of cryptococcosis by detecting antigenaemia in HIV-infected patients in the State of Para, Brazil. A latex Cryptococcus antigen detection kit was used to test 418 serum samples from HIV-infected patients seen at two Infectious Disease Specialized Units in the State of Para. The C. neoformans antigenaemia prevalence was 2.6%, and titres reached 1:8. The cases occurred mainly in asymptomatic females, and 45% presented CD4(+) T lymphocyte counts of fewer than 200 cells/mm(3). These results show the importance of early C. neoformans antigenaemia detection to prevent fungal disease.

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Paracoccidioidomycosis, or PCM, was described by Adolfo Lutz 105 years ago. Since then the disease has taken a prominent position among the systemic fungal infections because it mainly affects individuals in the most productive years of their lives in various countries of Latin America. In Brazil, the disease is considered endemic in some regions. However, it is still a neglected disease. With the recent discovery that Paracoccidioides brasiliensis is not the only species of this genus, numerous studies have contributed to better understanding and recognition of this pathogen and its pathology in many aspects, such as the epidemiological, clinical, and therapeutic aspects.

A reação em cadeia da polimerase usada para amplificação de uma seqüência interna de um fragmento previamente amplificado (nested-PCR) foi investigada como uma alternativa complementar a pesquisa de bacilos álcool ácido resistentes e a cultura do Mycobacterium tuberculosis em meio de Lowenstein-Jensen. Foram investigadas 144 amostras de escarro de pacientes suspeitos de tuberculose encaminhados ao Laboratório de Tuberculose do Instituto Evandro Chagas em Belém, no período de junho de 2002 a dezembro de 2003. Das 144 amostras, 121 foram caracterizadas como tuberculose, 119 foram positivas na cultura, 95 na baciloscopia e 128 na nested-PCR. A sensibilidade da nested-PCR foi 96% (116/121), enquanto a especificidade foi 48% (11/23). A nested-PCR poderá ser uma ferramenta complementar para o diagnóstico da tuberculose, pois apresenta sensibilidade equivalente à cultura, no entanto, necessita de maiores avaliações visando minimizar o número de resultados falso-positivos.

The genus Cryptococcus includes at least 37 different species, of which, two are important human pathogens: Cryptococcus neoformans and Cryptococcus gattii. These fungi are opportunistic pathogens and etiologic agents of cryptococcosis disease in humans and animals. A variety of virulence factors interfere with the establishment of cryptococcal infection is usually acquired via inhalation of environmental basidiospores or desiccated yeasts. Cryptococcosis has gained medical importance over the last decade due to the AIDS pandemic, and become an emerging pathogen of immunocompetent individuals, especially in children. This disease in humans may involve every tissue, including cutaneous and pulmonary sites, but the most serious manifestation is central nervous system involvement with meningoencephalitis. In this review, we briefly described the taxonomy, the fungus biology, epidemiology and clinical manifestations of cryptococcosis in immunocompetent and immunocompromised individuals.