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2016, Number 1

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Rev Clin Esc Med 2016; 6 (1)

Perfil epidemiológico y respuesta terapéutica de la infección por Cryptococcus sp. en pacientes de Costa Rica en el Hospital San Juan de Dios, Período 2008-2012

Ávila SD, Villalobos ZMA

Language: Spanish
References: 44
Page: 8-30
PDF size: 1047.51 Kb.


ABSTRACT

Background: Cryptoccosis is an invasive mycosis due to Criptococcus neoformans. This infection affect mainly inmunosupromised patients, particularly with HIV, and also may occur in inmunocompetents. The most common clinical presentation are meningitis and pulmonary.
Methods and materials: This work is aim to determinate the therapeutic response of the patients with cryptococcosis in Hospital San Juan de Dios, in a period between 2008-2012; with the diagnosis made in the bacteriology laboratory. The data was obtained by an observational study of medical file of 33 patients.
Results: 78,8 % of the patients were male with an age average of 40,1 ± 11.9 years. 72,7% were VIH positive, 20% were inmunocompetents and 9.1% with therapeutic inmunossupression due mainly to autoinmune disorders. The clinical presentation were 72.7 % with meningitis, 12.2 % pulmonar, 9.1 % disseminated and 6.1 % cutaneous. Meningeal presentation was predominant in HIV positives and pulmonary in inmunocompetents. The predominant species was C. neoformans in 87.9 %, C. laurenti in 9.1 % and C. uniguttulatus in 3%. The indian ink as diagnostic tool had a sensibility of 25 % in HIV negative and 58 % en HIV positives. 100 % of HIV patients and 44 % of HIV negatives were given with anphotericin B deoxycolate as initial treatment. The 30 % of HIV patients die and none of HIV negatives.
Conclusions: Cryptococcosisis a fungal disease that affect mainly young adults inmunocompromised with HIV at AIDS phase. Meningitis is the most frequent form in HIV patients and pulmonary was in inmunocompetents.All the coinfected patients were given with anphotericin B deoxycolateand in spite of that they had a 30 % mortality.


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