Palavras-chave
Meningite criptocócica. Imunodeficiência. Diagnóstico. Terapêutica.
Como Citar
Cerqueira Simões Braudes, I., Thaine Teodoro, D., Mendes da Silva Santos, A. E. ., Ferreira Firmino, F., Maria Senhorinha, G., & Sena de Lucena, L. (2021). NEUROCRIPTOCOCOSE: UMA DOENÇA QUE NÃO ABRE ESPAÇO PARA NEGLIGÊNCIA EM PACIENTES HIV POSITIVOS. Estudos Avançados Sobre Saúde E Natureza, 1. Recuperado de https://periodicojs.com.br/index.php/easn/article/view/206
Resumo
INTRODUÇÃO Composto por cerca de 30 espécies, o gênero Cryptococcus possui duas espécies de maior relevância clínica em humanos, C. neoformans e C.gattii. A primeira delas não foi considerada espécie de alta morbidade, inicialmente, mas na década de 1980, com a instituição do vírus da imunodeficiência humana (HIV), esse cenário mudou. Desde então passou a ser considerada como a micose com maior risco de vida para pacientes vivendo com o HIV, sendo responsável por cerca de 625.000 mortes anuais. OBJETIVO Determinar os principais pontos da neurocriptococose na população com HIV. METODOLOGIA A busca dos artigos foi realizada nas bases de dados MEDLINE/PUBMED e BVS. Os descritores utilizados foram escolhidos na plataforma BIREME em português e inglês, e foram respectivamente: Meningite Criptocócica/ Meningitis, Cryptococcal; Síndrome de Imunodeficiência Adquirida/ Acquired Immunodeficiency Syndrome; Diagnóstico/Diagnosis; Terapêutica/ Therapeutics; Sinais e Sintomas/ Signs and Symptoms. Outros textos foram escolhidos durante o percurso da leitura dos artigos das bases de dados, conforme as referências bibliográficas. No total, 35 artigos foram selecionados para compor essa revisão narrativa. DESENVOLVIMENTO A criptococose apresenta maior prevalência em áreas urbanas de países com clima tropical e subtropical. O fungo em questão é encontrado em fezes de pombos e a infecção ocorre por inalação. Tal levedura apresenta tropismo para o sistema nervoso central em decorrência, principalmente, da imunidade ineficaz. A alta morbidade, sobretudo, ocorre nos pacientes com contagem de células TCD4 menor que 100/mL, vista em pacientes HIV positivo. CONSIDERAÇÕES FINAIS A criptococose é a patologia de maior prevalência na população com HIV e a que confere maior morbidade nesse grupo. Ela revela clínica plural, sendo a neurocriptococose a primeira manifestação oportunística nesse grupo. As taxas de mortalidade são altas e desiguais entre os países desenvolvidos e subdesenvolvidos, inclusive, diretamente relacionadas à escolha da terapêutica inicial.
Referências
1. Azambuja, Aline et al (2018), “Cryptococcal Meningitis: A Retrospective Cohort of a Brazilian Reference Hospital in the Post-HAART Era of Universal Access”, Canadian Journal of Infectious Diseases and Medical Microbiology, 2018. Consultado a 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6093042/pdf/CJIDMM2018-6512468.pdf.
2. Beardsley, Justin et al (2016), “Adjunctive Dexamethasone in HIV-Associated Cryptococcal Meningitis”, The New England Journal of Medicine, 374, 542-554. Consultado a 25.04.2021, em https://www.nejm.org/doi/10.1056/NEJMoa1509024.
3. Braude, Abraham et al (1986), “Infectious Diseases and Medical Microbiology”, Philadelphia: WB Saunders Company, 564-570; [5º ed.]
4. Brizendine, Kyle et al (2013), “Predictors of mortality and differences in clinical features among patients with cryptococcosis according to immune status”, Plos One, 8(3), e60431. Consultado 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3608592/pdf/pone.0060431.pdf.
5. Casadevall, Arturo et al (2000), “Melanin and virulence in Cryptococcus neoformans”, Current Opinion in Microbiology, 3(4), 354-358. Consultado a 25.04.2021 em: https://doi.org/10.1016/S1369-5274(00)00103-X.
6. Chayakulkeeree, Methee; Perfect, John (2006), “Cryptococcosis”, Infectious Disease Clinics of North America, 20(3), 507-544. Consultado a 25.04.2021, em https://www.sciencedirect.com/science/article/abs/pii/S0891552006000602?via%3Dihub.
7. Day, Jeremy et al (2013), “Combination Antifungal Therapy for Cryptococcal Meningitis”, The new england journal of medicine, 368(14), 1291-1302. Consultado a 25.04.2021, em https://www.nejm.org/doi/full/10.1056/nejmoa1110404.
8. Firacative, Carolina et al (2018), “The status of cryptococcosis in Latin America”, Memórias do Instituto Oswaldo Cruz, 113(7), 1-23. Consultado a 25.04.2021, em https://www.scielo.br/pdf/mioc/v113n7/0074-0276-mioc-113-7-e170554.pdf.
9. Gazzoni, Alexandra Flávia et al (2010), “Unusual morphologies of Cryptococcus spp. in tissue specimens: report of 10 cases”, Instituto de Medicina Tropical de São Paulo, 52(3), 145-149. Consultado a 20.04.2021, em https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652010000300006.
10. Graybill, John et al (2000), “Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis”, Clinical Infectious Diseases, 30(1), 47-54. Consultado a 25.04.2021, em https://doi.org/10.1086/313603.
11. Hajjeh, Rana et al (1999), “Cryptococcosis: Population-Based Multistate Active Surveillance and Risk Factors in Human Immunodeficiency Virus—Infected Persons”, The Journal of Infectious Diseases, 179(2), 449-454. Consultado a 20.04.2021, em https://academic.oup.com/jid/article/179/2/449/1000299.
12. He, Jiang et al (2016), “P1028 Comparing 2 strategies for selecting low density SNPs for imputation-mediated, multiple-trait genomic prediction in a U.S. Holstein population”, Journal of Animal Science, 94(4), 28-29. Consultado a 25.04.2021, em https://academic.oup.com/jas/article-abstract/94/suppl_4/28/4740894?redirectedFrom=fulltext.
13. Jackson, Arthur; Van der Horst, Charles (2012), “New Insights in the Prevention, Diagnosis, and Treatment of Cryptococcal Meningitis”, AIDS Rep., 9 (3): 267-77. Consultado a 20.04.2021, em https://pubmed.ncbi.nlm.nih.gov/22763808/.
14. Knoke, Manfred; Schwesinger, Gunther (1994), “One hundred years ago: the history of crytococcosis in Greifswald. Medical mycology in the nineteenth century”, Mycoses, 37(7-8), 229-233. Consultado a 20.04.2021, em https://doi.org/10.1111/j.1439-0507.1994.tb00418.x.
15. Kwon-Chung, Kyung; Rhodes, Julia (1986), “Encapsulation and Melanin Formation as Indicators of Virulence in Cryptococcus neoformans”, Infection and Imunity, 51(1), 218-223. Consultado a 25.04.2021, em https://iai.asm.org/content/iai/51/1/218.full.pdf.
16. Liliang, Po-Chou (2002), “Use of ventriculoperitoneal shunts to treat uncontrollable intracranial hypertension in patients who have cryptococcal meningitis without hydrocephalus”, Clinical Infection Diseases, 34(12), E64-8. Consultado a 25.04.2021, em https://doi.org/10.1086/340525.
17. Makadzange, Azure T; Mchugh, Grace (2014), “New Approaches to the Diagnosis and Treatment of Cryptococcal Meningitis”, Seminars in Neurology, 34 (01): 047-060. Consultado a 20.04.2021, em https://ew7re4harkvb6xxgmc375wyhue-adv7ofecxzh2qqi-thieme-connect-de.translate.goog/products/ejournals/html/10.1055/s-0034-1372342#JR00912-2.
18. Maziarz, Eileen; Perfect, John (2016), “Cryptococcosis”, Infect Dis Clin North Am, 30(1), 179-206. Consultado a 20.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808417/.
19. Mitchell, Thomas; Perfect, John (1995), “Cryptococcosis in the Era of AIDS—100 Years after the discovery of cryptococcus neoformans”, Clinical Microbiology Reviews, 8(4), 515-548. Consultado a 25.04.2021, em https://cmr.asm.org/content/cmr/8/4/515.full.pdf.
20. Neuville, Ségolène at al (2002), “Physiopathology of meningoencephalitis caused by Cryptococcus neoformans”, Annales de Medecine Interne, 153(5), 323-328. Consultado a 25.04.2021, em https://pubmed.ncbi.nlm.nih.gov/12442078/.
21. Sabetta, James; Andriole, Vincent (1985), “Cryptococcal infections of the central nervous System”, Medical Clinics of North America, 69(2), 333-344. Consultado a 25.04.2021, em https://www.sciencedirect.com/science/article/abs/pii/S002571251631046X?via%3Dihub.
22. Spec, Andrej et al (2016), “End-stage liver disease is a strong predictor of early mortality in cryptococcosis”, Open Forum Infectious Diseases, 3(1), ofv197. Consultado a 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730110/pdf/ofv197.pdf.
23. Spec, Andrej; Powderly, William (2018), “Cryptococcal meningitis in AIDS”, The Neurology of HIV Infection, 152(3), 139-150. Consultado a 20.04.2021, em https://www.sciencedirect.com/science/article/pii/B9780444638496000116?via%3Dihub.
24. Steen, Barbara et al (2002), “Temperature-regulated transcription in the pathogenic fungus Cryptococcus neoformans”, Genome Research, 12(9), 1386-1400. Consultado a 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC186651/pdf/05X.pdf.
25. Park, Benjamin et al (2009), “Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS”, AIDS, 23, 525-530. Consultado a 20.04.2021, em https://journals.lww.com/aidsonline/Fulltext/2009/02200/Estimation_of_the_current_global_burden_of.12.aspx.
26. Sun, Feng et al (2020), “A study for precision diagnosing and treatment strategies in difficult-to-treat AIDS cases and HIV-infected patients with highly fatal or highly disabling opportunistic infections: Study protocol for the optimal early intervention for cryptococcal antigenemia in HIV-infected patients”, Medicine, 99(44), 1-6. Consultado a 25.04.2021, em http://dx.doi.org/10.1097/MD.0000000000022874.
27. Perfect, John et al (1987), “Effects of antifungal agents and gamma interferon on macrophage cytotoxicity for fungi and tumor cells”, The Journal of Infectious Diseases, 156(2), 316-323. Consultado a 25.04.2021, em https://academic.oup.com/jid/article-abstract/156/2/316/817461?redirectedFrom=fulltext.
28. Perfect, John et al (2010), “Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America”, Clinical Infectious Diseases, 50(3), 291-322. Consultado a 25.04.2021, em https://doi.org/10.1086/649858.
29. Pitisuttithum, Punnee et al (2001), “A Prospective Study of AIDS-associated Cryptococcal Meningitis in Thailand Treated with High-dose Amphotericin B”, Journal of Infection, 43(4), 226-233. Consultado a 25.04.2021, em https://doi.org/10.1053/jinf.2001.0916.
30. Powderly, William (1993), “Cryptococcal meningitis and AIDS”, Clinical Infection Diseases, 17(5), 837-842. Consultado a 20.04.2021, em https://academic.oup.com/cid/article-abstract/17/5/837/320496?redirectedFrom=fulltext.
31. Powderly, William (1996), “Recent Advances in the Management of Cryptococcal Meningitis in Patients with AIDS”, Clinical Infection Diseases, 22(2), S119–S123. Consultado a 25.04.2021, em https://doi.org/10.1093/clinids/22.Supplement_2.S119.
32. Powderly, William (2000), “Current Approach to the Acute Management of Cryptococcal Infections”, Journal of Infection, 41(1), 18-22. Consultado a 25.04.2021, em https://doi.org/10.1053/jinf.2000.0696.
33. Rajasingham, Radha et al (2017), “Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis”, The Lancet Infectious Diseases, 17(8), 873-881. Consultado a 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818156/pdf/nihms886671.pdf.
34. van Duin, David et al (2002), “Melanization of Cryptococcus neoformans and Histoplasma capsulatum reduces their susceptibilities to amphotericin B and caspofungin”, Antimicrob Agents Chemother, 46(11), 3394-3400. Consultado a 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC128748/pdf/0533.pdf.
35. Wang, Jinlin et al (2015), “The Role of Cryptococcus in the Immune System of Pulmonary Cryptococcosis Patients”, Plos One, 10(12), e0144427. Consultado a 25.04.2021, em https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0144427.
2. Beardsley, Justin et al (2016), “Adjunctive Dexamethasone in HIV-Associated Cryptococcal Meningitis”, The New England Journal of Medicine, 374, 542-554. Consultado a 25.04.2021, em https://www.nejm.org/doi/10.1056/NEJMoa1509024.
3. Braude, Abraham et al (1986), “Infectious Diseases and Medical Microbiology”, Philadelphia: WB Saunders Company, 564-570; [5º ed.]
4. Brizendine, Kyle et al (2013), “Predictors of mortality and differences in clinical features among patients with cryptococcosis according to immune status”, Plos One, 8(3), e60431. Consultado 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3608592/pdf/pone.0060431.pdf.
5. Casadevall, Arturo et al (2000), “Melanin and virulence in Cryptococcus neoformans”, Current Opinion in Microbiology, 3(4), 354-358. Consultado a 25.04.2021 em: https://doi.org/10.1016/S1369-5274(00)00103-X.
6. Chayakulkeeree, Methee; Perfect, John (2006), “Cryptococcosis”, Infectious Disease Clinics of North America, 20(3), 507-544. Consultado a 25.04.2021, em https://www.sciencedirect.com/science/article/abs/pii/S0891552006000602?via%3Dihub.
7. Day, Jeremy et al (2013), “Combination Antifungal Therapy for Cryptococcal Meningitis”, The new england journal of medicine, 368(14), 1291-1302. Consultado a 25.04.2021, em https://www.nejm.org/doi/full/10.1056/nejmoa1110404.
8. Firacative, Carolina et al (2018), “The status of cryptococcosis in Latin America”, Memórias do Instituto Oswaldo Cruz, 113(7), 1-23. Consultado a 25.04.2021, em https://www.scielo.br/pdf/mioc/v113n7/0074-0276-mioc-113-7-e170554.pdf.
9. Gazzoni, Alexandra Flávia et al (2010), “Unusual morphologies of Cryptococcus spp. in tissue specimens: report of 10 cases”, Instituto de Medicina Tropical de São Paulo, 52(3), 145-149. Consultado a 20.04.2021, em https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0036-46652010000300006.
10. Graybill, John et al (2000), “Diagnosis and management of increased intracranial pressure in patients with AIDS and cryptococcal meningitis”, Clinical Infectious Diseases, 30(1), 47-54. Consultado a 25.04.2021, em https://doi.org/10.1086/313603.
11. Hajjeh, Rana et al (1999), “Cryptococcosis: Population-Based Multistate Active Surveillance and Risk Factors in Human Immunodeficiency Virus—Infected Persons”, The Journal of Infectious Diseases, 179(2), 449-454. Consultado a 20.04.2021, em https://academic.oup.com/jid/article/179/2/449/1000299.
12. He, Jiang et al (2016), “P1028 Comparing 2 strategies for selecting low density SNPs for imputation-mediated, multiple-trait genomic prediction in a U.S. Holstein population”, Journal of Animal Science, 94(4), 28-29. Consultado a 25.04.2021, em https://academic.oup.com/jas/article-abstract/94/suppl_4/28/4740894?redirectedFrom=fulltext.
13. Jackson, Arthur; Van der Horst, Charles (2012), “New Insights in the Prevention, Diagnosis, and Treatment of Cryptococcal Meningitis”, AIDS Rep., 9 (3): 267-77. Consultado a 20.04.2021, em https://pubmed.ncbi.nlm.nih.gov/22763808/.
14. Knoke, Manfred; Schwesinger, Gunther (1994), “One hundred years ago: the history of crytococcosis in Greifswald. Medical mycology in the nineteenth century”, Mycoses, 37(7-8), 229-233. Consultado a 20.04.2021, em https://doi.org/10.1111/j.1439-0507.1994.tb00418.x.
15. Kwon-Chung, Kyung; Rhodes, Julia (1986), “Encapsulation and Melanin Formation as Indicators of Virulence in Cryptococcus neoformans”, Infection and Imunity, 51(1), 218-223. Consultado a 25.04.2021, em https://iai.asm.org/content/iai/51/1/218.full.pdf.
16. Liliang, Po-Chou (2002), “Use of ventriculoperitoneal shunts to treat uncontrollable intracranial hypertension in patients who have cryptococcal meningitis without hydrocephalus”, Clinical Infection Diseases, 34(12), E64-8. Consultado a 25.04.2021, em https://doi.org/10.1086/340525.
17. Makadzange, Azure T; Mchugh, Grace (2014), “New Approaches to the Diagnosis and Treatment of Cryptococcal Meningitis”, Seminars in Neurology, 34 (01): 047-060. Consultado a 20.04.2021, em https://ew7re4harkvb6xxgmc375wyhue-adv7ofecxzh2qqi-thieme-connect-de.translate.goog/products/ejournals/html/10.1055/s-0034-1372342#JR00912-2.
18. Maziarz, Eileen; Perfect, John (2016), “Cryptococcosis”, Infect Dis Clin North Am, 30(1), 179-206. Consultado a 20.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5808417/.
19. Mitchell, Thomas; Perfect, John (1995), “Cryptococcosis in the Era of AIDS—100 Years after the discovery of cryptococcus neoformans”, Clinical Microbiology Reviews, 8(4), 515-548. Consultado a 25.04.2021, em https://cmr.asm.org/content/cmr/8/4/515.full.pdf.
20. Neuville, Ségolène at al (2002), “Physiopathology of meningoencephalitis caused by Cryptococcus neoformans”, Annales de Medecine Interne, 153(5), 323-328. Consultado a 25.04.2021, em https://pubmed.ncbi.nlm.nih.gov/12442078/.
21. Sabetta, James; Andriole, Vincent (1985), “Cryptococcal infections of the central nervous System”, Medical Clinics of North America, 69(2), 333-344. Consultado a 25.04.2021, em https://www.sciencedirect.com/science/article/abs/pii/S002571251631046X?via%3Dihub.
22. Spec, Andrej et al (2016), “End-stage liver disease is a strong predictor of early mortality in cryptococcosis”, Open Forum Infectious Diseases, 3(1), ofv197. Consultado a 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730110/pdf/ofv197.pdf.
23. Spec, Andrej; Powderly, William (2018), “Cryptococcal meningitis in AIDS”, The Neurology of HIV Infection, 152(3), 139-150. Consultado a 20.04.2021, em https://www.sciencedirect.com/science/article/pii/B9780444638496000116?via%3Dihub.
24. Steen, Barbara et al (2002), “Temperature-regulated transcription in the pathogenic fungus Cryptococcus neoformans”, Genome Research, 12(9), 1386-1400. Consultado a 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC186651/pdf/05X.pdf.
25. Park, Benjamin et al (2009), “Estimation of the current global burden of cryptococcal meningitis among persons living with HIV/AIDS”, AIDS, 23, 525-530. Consultado a 20.04.2021, em https://journals.lww.com/aidsonline/Fulltext/2009/02200/Estimation_of_the_current_global_burden_of.12.aspx.
26. Sun, Feng et al (2020), “A study for precision diagnosing and treatment strategies in difficult-to-treat AIDS cases and HIV-infected patients with highly fatal or highly disabling opportunistic infections: Study protocol for the optimal early intervention for cryptococcal antigenemia in HIV-infected patients”, Medicine, 99(44), 1-6. Consultado a 25.04.2021, em http://dx.doi.org/10.1097/MD.0000000000022874.
27. Perfect, John et al (1987), “Effects of antifungal agents and gamma interferon on macrophage cytotoxicity for fungi and tumor cells”, The Journal of Infectious Diseases, 156(2), 316-323. Consultado a 25.04.2021, em https://academic.oup.com/jid/article-abstract/156/2/316/817461?redirectedFrom=fulltext.
28. Perfect, John et al (2010), “Clinical Practice Guidelines for the Management of Cryptococcal Disease: 2010 Update by the Infectious Diseases Society of America”, Clinical Infectious Diseases, 50(3), 291-322. Consultado a 25.04.2021, em https://doi.org/10.1086/649858.
29. Pitisuttithum, Punnee et al (2001), “A Prospective Study of AIDS-associated Cryptococcal Meningitis in Thailand Treated with High-dose Amphotericin B”, Journal of Infection, 43(4), 226-233. Consultado a 25.04.2021, em https://doi.org/10.1053/jinf.2001.0916.
30. Powderly, William (1993), “Cryptococcal meningitis and AIDS”, Clinical Infection Diseases, 17(5), 837-842. Consultado a 20.04.2021, em https://academic.oup.com/cid/article-abstract/17/5/837/320496?redirectedFrom=fulltext.
31. Powderly, William (1996), “Recent Advances in the Management of Cryptococcal Meningitis in Patients with AIDS”, Clinical Infection Diseases, 22(2), S119–S123. Consultado a 25.04.2021, em https://doi.org/10.1093/clinids/22.Supplement_2.S119.
32. Powderly, William (2000), “Current Approach to the Acute Management of Cryptococcal Infections”, Journal of Infection, 41(1), 18-22. Consultado a 25.04.2021, em https://doi.org/10.1053/jinf.2000.0696.
33. Rajasingham, Radha et al (2017), “Global burden of disease of HIV-associated cryptococcal meningitis: an updated analysis”, The Lancet Infectious Diseases, 17(8), 873-881. Consultado a 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5818156/pdf/nihms886671.pdf.
34. van Duin, David et al (2002), “Melanization of Cryptococcus neoformans and Histoplasma capsulatum reduces their susceptibilities to amphotericin B and caspofungin”, Antimicrob Agents Chemother, 46(11), 3394-3400. Consultado a 25.04.2021, em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC128748/pdf/0533.pdf.
35. Wang, Jinlin et al (2015), “The Role of Cryptococcus in the Immune System of Pulmonary Cryptococcosis Patients”, Plos One, 10(12), e0144427. Consultado a 25.04.2021, em https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0144427.
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