Criptococose: estudo clínico-epidemiológico, laboratorial e das variedades do fungo em 96 pacientes Cryptococosis: clinical epidemiologycal laboratorial study and fungi varieties in 96 patients

• Published in: Revista da Sociedade Brasileira de Medicina Tropical
• Main Authors: Tomaz de Aquino Moreira, Marcelo Simão Ferreira, Rosineide Marques Ribas, Aércio Sebastião Borges
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 2006
• Subjects: Cryptococcus neoformans; Criptococose; Síndrome da imunodeficiência adquirida; Vírus da imunodeficiência humana; Cryptococcosis; Acquired immunodeficiency syndrome; Immunodeficiency human virus; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.1590/S0037-86822006000300005; https://doaj.org/article/4bdfc4a478b649bfaa6e9b81d37f555d

Estudo prospectivo foi realizado no Hospital de Clínicas da Universidade Federal de Uberlândia, entre março de 1998 e novembro de 2003, em 96 pacientes com diagnóstico clínico e laboratorial de criptococose, sendo 81,3% portadores de Aids. Cepas de Cryptococcus neoformans foram obtidas de diferentes amostras, sendo 77% em líquido cefalorraquidiano. A var neoformans foi isolada em 89 casos e a var gattii em 7. A meningoencefalite criptocócica (56,3% dos casos), foi a manifestação clínica mais descrita, seguida da fungemia (13,5%). Entre os fatores de risco, a AIDS (81,3%) foi o mais comumente associado à micose. A pesquisa direta do fungo realizada em 121 amostras demonstrou o microrganismo em 98,3%, com cultura (+) em todas. Dos pacientes, 59,4% foram tratados com anfotericina B ou derivados triazólicos, sendo que 72,9% evoluíram para óbito, em particular os portadores de AIDS (62,5%). Atualmente, a criptococose tem sido diagnosticada com muita freqüência em nosso meio e constitui uma das doenças oportunísticas de maior morbidade e mortalidade nos pacientes com AIDS. 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, ...