Capítulo 3: criptococose pulmonar

Abstract

on the agglutination reactions of capsular polysaccharide antigens. Serotype A and serotype D strains, as well as the AD hybrid, are classified as C. neoformans, whereas serotype B and serotype C strains have been classified as C. gattii. Serotype A strains have been designated C. neoformans var. grubii, whereas serotype D strains have been designated C. neoformans var. neoformans.(3) This classification was based on the differences in capsular structure and DNA between the strains, as well as on a complete comparison of the genomic sequencing of these two serotypes (strains).(3) In addition, based on new molecular data and on evolutionary studies, IntroductionCryptococcosis is an infection caused by the naturally encapsulated basidiomycete of the genus Cryptococcus, which has recently become the most relevant opportunistic fungal pathogen.(1) The infection caused by the species C. neoformans has become the most critically relevant opportunistic infection as a consequence of the AIDS epidemic. In addition, C. gattii recently caused an isolated cryptococcosis outbreak among apparently immunocompetent humans and animals on Vancouver Island, Canada. AbstractCryptococcosis is a systemic mycosis caused by two species of the encapsulated basidiomycetes, Cryptococcus neoformans and C. gattii, which, respectively, cause infection in immunocompromised individuals and in immunologically normal hosts. Patients with T-cell deficiencies are more susceptible to this infection. The spectrum of the disease ranges from asymptomatic pulmonary lesions to disseminated infection with meningoencephalitis. The medical relevance of cryptococcosis increased dramatically as a consequence of the AIDS epidemic and organ transplants.Keywords: Cryptococcus neoformans; Pneumonia; Acquired immunodeficiency syndrome; Amphotericin B; Fluconazole. ResumoCriptococose é uma micose sistêmica causada por duas espécies do basidiomiceto encapsulado, Cryptococcus neoformans e C. gattii, que, respectivamente, causam infecção em indivíduos imunocomprometidos e em hospedeiros imunocompetentes, respectivamente. Pacientes com deficiência em células T são mais suscetíveis. A infecção se inicia por lesões pulmonares assintomáticas e a doença disseminada frequentemente cursa com meningoencefalite. A importância médica da criptococose aumentou significativamente em consequência da epidemia da AIDS e dos transplantes de órgãos.

Clinical Laboratory Characteristics of Cryptococcosis in Patients Admitted to the Emergency Room Hospital das Clínicas, Federal University of Minas Gerais, Tertiary Reference of the Unified Health System: Retrospective Analysis from 2000 to 2013

“…Os criptocomas revelam-se como abscessos cerebrais ou cerebelares, sem apresentar estruturas fúngicas no líquor. [48][49][50][51][52][53][54][55] O diagnóstico da criptococose é determinado pelo encontro do fungo em material coletado, em geral, de punções liquóricas ou aspirações de tecidos afetados (corados pela tinta Nanquin), ou pela cultura em meio Ágar (Saboraud, Niger, L-dopa); ou ainda com base em provas sorológicas(aglutinação em látex para o antígeno polissacarídicocriptocócico, ELISA, reação em cadeia de polimerase). 2,55-67 Em alguns casos, só a cultura revela a presença do fungo.…”

Immune reconstitution inflammatory syndrome, with pulmonary and neurological cryptococcosis, in an HIV-negative patient

“…In immunocompromised patients, cryptococcosis is common and is mainly caused by inhalation of Cryptococcus neoformans or Cryptococcus gattii (1-4) . Many patients with cryptococcosis develop pulmonary colonization, which is often asymptomatic.…”

“…The presentations include masses and pulmonary consolidations (1,3) , gelatinous cystic formations in the brain, especially in the thalamus and basal nuclei (2) . The differential diagnoses include lung cancer with brain metastasis (3,4) . The diagnosis is made by identifying the fungus in sputum samples, bronchoalveolar lavage fluid, cerebrospinal fluid, histological sections, or culture (4) .…”

“…The differential diagnoses include lung cancer with brain metastasis (3,4) . The diagnosis is made by identifying the fungus in sputum samples, bronchoalveolar lavage fluid, cerebrospinal fluid, histological sections, or culture (4) . Fluconazole and amphotericin-B are therapeutic options (2,4) .…”

Características clínicas, epidemiológicas e laboratoriais da criptococose no Distrito Federal no período de 2006 a 2013

“…A Criptococose mostrou-se prevalente nas Regiões Sul e Sudeste, com maior número de casos em homens, muito embora venha sendo observado o crescimento do número de casos em mulheres (Prado et al, 2009 (Correa et al, 1999;Santos, 2000;Severo et al, 2009). Nessas regiões, a meningoencefalite criptocócica ocorre em jovens e crianças com elevada morbidade e letalidade (37 a 49%).…”