Updating: Cryptococcosis Diagnostic Aspects

Abstract

Currently, AIDS represents the most common risk factor for the development of cryptococcosis. Despite of rapid scale-up of antiretroviral therapy programs and global investement in HIV care over the past decade, the decline in incidende and mortality rates associated with cryptococcosis has not been commensurate. This article puts into context recent diagnostics studies and morphologies-with special attention to laboratory diagnosis based on classical mycology: (a) histopathology through the histochemical techniques of hematoxilin and eosin, periodic acid-Schiff, and Grocott's silver, as well special histochemical techniques such as Mayer's mucicarmine and Fontana-Masson; (b) cultures by Sabouraud's medium, brain-heart infusion agar, canavanineglycine-bromothymol blue agar, in addition to niger seed agar medium and lysis-centrifugation blood-culturing technique; (c) serology by cryptococcal antigen test and cryptococcal antigen lateral flow assay. In this paper, we also discussed the new rapid point-of-care lateral flow assay to be used to screening HIV-infected person with CD4 counts of less than 100 cells /µL. It is noteworthy that laboratory findings should be interpreted considering the clinical and epidemiological history of all patients. Consequently, diagnostic tools are only properly used, if the treating physician is aware of the propensity of patients to acquire a fungal infection.

Neurocriptococose e Sarcoma de Kaposi associados à infecção por HIV: relato de caso.

“…No presente trabalho, o diagnóstico foi feito inicialmente pela rotina de líquor e depois confirmado pela cultura que encontrou o microrganismo Cryptococcus neoformans. Além disso, evidenciou-se, também, a hipertensão intracraniana, fator que indica pior prognóstico do paciente 10,11 .…”

“…O diagnóstico laboratorial da criptococose é realizado por meio de cultura de aspirado traqueal, fragmentos de tecido e amostras de trato respiratório, rotina e cultura de líquor (LCR) e aspirados de lesões cutâneas. Como exames auxiliares, pode-se utilizar sorologias, análises histopatológicas e bioquímicas, técnicas moleculares e exames de imagem 10,11 .…”