Cryptococcus neoformans e Cryptococcus gattii: quimiotipagem e correlação com criptococose em hospitais públicos de João Pessoa - PB.

Abstract

Cryptococcosis is a mycosis in nature systemic and cosmopolitan, caused by infection with Cryptococcus neoformans (opportunistic) and C . gattii (primary pathogen), whose CNS involvement occurs in a slick. The objecti ve was to verify the diagnosis of infection, species identification, clinical forms, risk factors, geographic distribution and clinical parameters in immunocompetent or immunocompromised , with clinical suspicion of cryptococcosis, assisted in hospitals in João Pessoa - PB from 1998 to 2012. The data were collected through medical records, epidemiological and medical records, as the case definition was established by the Health of Ministry.W ere diagnosed 25 cases of cryptoco ccosis, 23 cases of cryptococcosis m eningitis, 1 case of pulmonary cryptococcosis more cryptococcosis meningitis and 1 case c utaneous cryptococcosis, with a prevalence of 12.2%. Regarding the origin of the patients, 40% lived in the Mesorregião da Mata Paraibana, 24% the Agreste Paraibano an d 8% the Sertão Para ibano , the remaining 8% belonged to the state of Pernambuco and in 20% there was no record. Most patients were male with 68% of cases, aged 21 - 50 years, and 32% of females were younger than 17 years. C. neoformans was responsible for 56 % of cases and C. gattii by 24%, and 20% of the cases could not be biotyped . The signs and symptoms were more frequent disorientation, unconsciousness, fever, vomiting, stiff neck, headache, visual changes and irritability (multiple response). AIDS was the main risk factor (36%), followed by SE L (4%), HIV + (4%), sepsis + lymphoma (4%) and recorded as immunocompromised individuals (4%). Of the remainder, 32% had no underlying disease and 16% had no record. The gravity, 96% had spread to the CNS and 4% local ized cutaneous form. The treatment regimen was based on amphotericin B and liposomal form, and fluconazole in varying concentrations. In this study, 32% patients died, 48% were discharged and 20% had no record.