Document Detail


Clinical, Epidemiological and Outcome Features of Patients with Cryptococcosis in Uberaba, Minas Gerais, Brazil.
MedLine Citation:
PMID:  22130645     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Nearly one million of cryptococcosis cases occur yearly around the world, involving mainly HIV-infected patients who are not receiving antiretroviral therapy (ART) or present poor adherence. This study aims to evaluate epidemiological, clinical and outcome aspects of patients with cryptococcosis from 1998-2010. Patients were prospectively recruited, and their medical and laboratory records were reviewed. A total of 131 cases were included, and of these, 119 (90.83%) had AIDS, 4 received a renal transplant, 2 presented systemic lupus erythematosus and 6 (4.6%) were apparently immunocompetent. Ninety-one (69.46%) were men, and the median age was 38.7 years. Cryptococcal meningitis (CM) was diagnosed in 103 (78.62%), whereas 28 (21.38%) had cryptococcal infection in other sites. Of patients with CM, 94 (91.26%) had AIDS being cryptococcosis the first defining illness in 61 (64.9%), while 37 (60.65%) of them presented simultaneously both diagnosis. Headache, altered mental status, papilledema and seizures at admission were significatively associated with a poor outcome. Of 163 different isolates, 155 (95.09%) were Cryptococcus neoformans and eight (4.88%) Cryptococcus gattii. Antifungal therapy was warranted in 8 (87.4%) patients with CM, but 46 (51.1%) died during the first days or weeks. Of 28 patients without CM, 21 (75%) received treatment, but 6 (28.6%) died. The poor outcome among this case series was similar to that reported from other developing countries, but it is paradoxal in Brazil where the ART is at free disposal in the public health services. Despite, at least 60-70% of patients present advanced immunosuppression when they receive the AIDS diagnosis.
Authors:
Delio José Mora; Eduardo Rodrigues da Cunha Colombo; Kennio Ferreira-Paim; Leonardo Eurípedes Andrade-Silva; Gabriel Antonio Nogueira Nascentes; Mario León Silva-Vergara
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-1
Journal Detail:
Title:  Mycopathologia     Volume:  -     ISSN:  1573-0832     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7505689     Medline TA:  Mycopathologia     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Infectious Diseases Department, Triângulo Mineiro Federal University, Uberaba, Minas Gerais, Brazil.
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