Neurocriptococose na infância: relato de três casos na primeira década de vida

Abstract

The authors report three cases of central nervous system cryptococcosis in children in the first decade of life, from Rio Grande do Sul State, Brazil. Diagnosis was supported by demonstration of Cryptococcus neoformans with India-ink preparations of the spinal fluid and Sabouraud's media culture. Clinical presentation included acute, subacute and chronic forms. Increased intracranial pressure and hydrocephalus were the complications during the course of the disease, and a ventriculoperitoneal shunt was used in one case. Undernutrition was associated with all cases and tubercle bacillus infection with one. Specific therapy was administered to the three patients. One patient was cured and the other two died.

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

“…Many patients with cryptococcosis develop pulmonary colonization, which is often asymptomatic. The symptoms become pronounced when they evolve to meningoencephalitis, presenting high tropism for the leptomeninges (1-5) . The presentations include masses and pulmonary consolidations (1,3) , gelatinous cystic formations in the brain, especially in the thalamus and basal nuclei (2) .…”

“…Malnutrition is a known cause of immunodeficiency, affecting the mechanisms of adaptive immunity (5,6) . Some patients with acquired immunodeficiency syndrome or immunosuppression develop IRIS, in which the immune system begins to recover, responding to a previously acquired opportunistic infection with an exuberant inflammatory response that paradoxically causes a worsening of the symptoms (2,7,8) .…”