Criptococose: estudo clínico-epidemiológico, laboratorial e das variedades do fungo em 96 pacientes

Abstract

Ninety-six patients with cryptococcosis confirmed by clinical and laboratorial diagnosis were assessed in a prospective study in a University Hospital from March 1998 to November 2003; of these, 81.3% were HIV seropositive patients. Cryptococcus neoformans was isolated from different samples, of which the cerebrospinal fluid 74 (77%) was the most frequent. C. neoformans var neoformans was isolated in 89 cases, where as C. neoformans var gattii was isolated in 7. Cryptococcal meningoencephalitis was detected in 56.3% cases. It was the most frequent unique clinical manifestation and the fungus was detected in the bloodstream in 13.5% of the patients. Among the risk factors, AIDS (81.3%) was the most frequently associated with mycosis. Direct examination carried out on 121 samples revealed the microorganism in 98.3% of them, while the culture was positive for all samples. Most of the patients (59.4%) were treated with amphotericin B or with triazoles, however 72.9% of them ended in death, in particular those patients with positive tests for the HIV (62.5%). Nowadays, cryptococcosis has been frequently diagnosed in our region and represents one of the opportunistic diseases with the highest morbidity and mortality rates in patients with AIDS.

Criptococosis en Colombia: resultados de la encuesta nacional, 2006-2010

“…When analyzing the data obtained for the period 2006-2010, it was observed that cryptococcosis is seen in all ages, even in the boundaries of life; between them we found 2 patients less than 15 years of age, which is in agreement with the low proportion of children known to develop cryptococcosis in global reports, even in endemic areas for this disease, except Brazil, where the prevalence in children is higher (19,9%) (16,(36)(37)(38)(39).…”

Cryptococcal meningitis in Rio de Janeiro State, Brazil, 1994-2004

“…In Brazil, cryptococcosis case-fatality with or without underlying disease ranges from 45% to 65% 7,17,39 . In the series by Rozembaum & Gonçalves 20 in Rio de Janeiro from 1960 to 1989, overall case-fatality in the sample was 52.3% (65.7% in AIDS patients, 38.6% in non-immune suppressed patients, and 36.8% in patients with other predisposing conditions).…”

“…This regimen, proposed by the Infectious Diseases Society of America, consists of the administration of an antifungal agent for one year in patients without HIV infection, and in those with AIDS, administration of an antifungal for at least two years and suspension if there is sustained immune recovery with HAART 27,43 . With the introduction of maintenance therapy, the risk of relapse dropped to values ranging from 2% to 4% 39,40 .…”

Cryptococcus spp. em excretas de Columba livia (pombos domésticos) provenientes de um hospital universitário no Sul do Brasil

“…Duas são as principais espécies patogênicas, C. neoformans e C. gattii, as quais se distinguem tanto por aspectos ecológicos, bioquímicos, antigênicos e genéticos (Reolon et al, 2004). O fungo C. neoformans tem distribuição mundial e seu habitat natural são as excretas de aves, especialmente de Columba livia (pombos domésticos) (Faria et al, 2010).…”