Criptococosis gástrica en paciente VIH

Gastric cryptococcosis: an unusual presentation of a common opportunistic disorder

“…AIDS patients with gastrointestinal cryptococcosis generally have an exceedingly low CD4 cell count. Most reported cases had less than 50 CD4 cells/mm 3 3 , 10 - 12 , 14 and concomitant cryptococcal meningoencephalitis is also common 2 , 5 - 7 , 10 , 11 , but some patients apparently had no evidence of neurologic disease 3 , 8 , 9 . Esophagogastroduodenoscopy followed by histopathology of biopsy samples have proved to be an invaluable diagnostic tool 2 - 7 , 11 .…”

“…The clinical presentation of gastric cryptococcosis has been described as symptoms of “gastroesophageal reflux including odynophagia” 4 , “epigastric abdominal pain and biliary vomiting” 5 , “odynophagia and intractable vomiting” 3 , “acute worsening of chronic watery diarrhea with melena” 6 and “chronic dysphagia with epigastralgia” 7 .…”

Colonic cryptococcosis as a rare presentation in HIV infection: a case report and review of the literature

“…In PLWH with severe immunosuppression (WHO clinical stage 3-4) with CD4 <50 cells/mL, gastrointestinal cryptococcal infection manifestations are chronic diarrhea, [6][7][8][9][10][11] fever, [6][7][8][9]12,13 and abdominal pain 6,7,10,[12][13][14][15][16][17][18] in those without ART, and abdominal pain with peritoneal irritation and fever in those that recently started ART. [19][20][21] In HIV and gastrointestinal cryptococcal coinfection, the most frequent localization is in the small intestine (duodenum, 6,[9][10][11]13,16,17,22 jejunum and ileum 12,14 ). The gastrointestinal injuries were ulcers and perforation, 9,10,12,14,18 and mucosal patch injuries.…”

“…CAT that included amphotericin B had better results 7,[12][13][14]17,21 in contrast with only one antifungal, either fluconazole 8,10 or amphotericin B. 16,18 In non-HIV patients, clinical manifestations are abdominal pain 15,[23][24][25][26][27] and melena 23,28 ; seven of these reports described a secondary immunosuppressive condition. 15,23,[25][26][27]29,30 Characteristics of gastrointestinal injuries were mass-like lesions, 26,28 lymphadenopathies, 23,25 ulcers, 15,23,27,29,30 and perforations.…”

Endoscopic Findings of Gastric Cryptococcosis in an Immunosuppressed Patient

“…In patients undergoing endoscopy, findings can vary from gastric ulcers, nodules, and whitish petechiae. [2][3][4][5] Gastric cryptococcosis is usually a manifestation of a disseminated infection, and the prognosis in most case reports is poor.…”