Keywords
Cryptococcal meningitis. Immunodeficiency. Diagnosis. Therapy.
How to Cite
Thaine Teodoro, D. ., Cerqueira Simões Braudes, I. ., Emanuel Mendes da Silva Santos, A. ., Ferreira Firmino, F. ., Maria Senhorinha, G. ., & Sena de Lucena, L. . (2021). NEUROCRYPTOCOCOSIS: : A DISEASE THAT DOES NOT OPEN SPACE FOR NEGLIGENCE IN HIV POSITIVE PATIENTS. Health and Society, 1(03). https://doi.org/10.51249/hes01.03.2021.354
Abstract
INTRODUCTION Composed of about 30 species, the genus Cryptococcus has two species of greater clinical relevance in humans, C. neoformans and C.gattii. The first one was not considered a high morbidity species, initially, but in the 1980s, with the institution of the human immunodeficiency virus (HIV), this scenario changed. Since then it has come to be considered the most life-threatening ringworm for patients living with HIV, accounting for about 625,000 deaths annually. OBJECTIVE To determine the main points of neurocriptococcosis in the population with HIV. METHODOLOGY The search for the articles was carried out in the MEDLINE/ PUBMED and BVS databases. The descriptors used were chosen on the BIREME platform in Portuguese and English, and were respectively: Meningitis, Cryptococcal; Acquired Immunodeficiency Syndrome; Diagnosis; Therapeutics; Signs and Symptoms. Other texts were chosen during the course of reading the articles in the databases, according to the bibliographic references. In total, 35 articles were selected to compose this narrative review. DEVELOPMENT Cryptococcosis is more prevalent in urban areas of countries with tropical and subtropical climates. The fungus in question is found in pigeon droppings and the infection occurs by inhalation. Such yeast has tropism for the central nervous system due mainly to ineffective immunity. High morbidity, above all, occurs in patients with a TCD4 cell count below 100/mL, seen in HIV-positive patients. FINAL CONSIDERATIONS Cryptococcosis is the pathology with the highest prevalence in the population with HIV and the one that confers the highest morbidity in this group. It reveals a plural clinic, with neurocriptococcosis being the first opportunistic manifestation in this group. Mortality rates are high and uneven between developed and underdeveloped countries, including those directly related to the choice of initial therapy.
References
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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.
Braude, Abraham et al (1986), “Infectious Diseases and Medical Microbiology”, Philadelphia: WB Saunders Company, 564-570; [5º ed.]
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.
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.
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.
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.
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.
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.
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.
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.
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.
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/.
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.
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.
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.
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.
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/.
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.
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/.
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.
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.
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.
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.
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.
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.
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/artiabstract/156/2/316/817461?redirectedFrom=fulltext.
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.
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.
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/artiabstract/17/5/837/320496?redirectedFrom=fulltext.
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.
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.
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.
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.
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
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.
Braude, Abraham et al (1986), “Infectious Diseases and Medical Microbiology”, Philadelphia: WB Saunders Company, 564-570; [5º ed.]
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.
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.
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.
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.
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.
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.
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.
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.
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.
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/.
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.
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.
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.
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.
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/.
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.
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/.
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.
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.
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.
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.
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.
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.
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/artiabstract/156/2/316/817461?redirectedFrom=fulltext.
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.
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.
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/artiabstract/17/5/837/320496?redirectedFrom=fulltext.
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.
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.
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.
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.
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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