Epidemiological, Clinical and Outcome Aspects of Patients with Cryptococcosis Caused by Cryptococcus gattii from a Non-endemic Area of Brazil
Cryptococcosis by Cryptococcus gattii occurs mainly in immunocompetent hosts, however, during the last decades, a growing number of cases in immunocompromised individuals have been noticed around the world. This report presents epidemiological, clinical and outcome aspects of patients with cryptococ...
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Veröffentlicht in: | Mycopathologia (1975) 2019-02, Vol.184 (1), p.65-71 |
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Sprache: | eng |
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Zusammenfassung: | Cryptococcosis by
Cryptococcus gattii
occurs mainly in immunocompetent hosts, however, during the last decades, a growing number of cases in immunocompromised individuals have been noticed around the world. This report presents epidemiological, clinical and outcome aspects of patients with cryptococcosis caused by this species from a non-endemic area in Brazil. Of 278
Cryptococcus
spp. clinical isolates recovered during the same period, 267 (96%) were molecularly identified as
Cryptococcus neoformans
VNI genotype and 11 (4%) as
C. gattii
VGII genotype by
URA
-5 RFLP. Of the 11
C. gattii
patients, eight were male, mean age of 47.5 years. Of these, four were HIV-infected, one was kidney transplanted, one presented low CD4
+
T cells values of unknown cause, another presented chronic liver disease meanwhile the remaining four were apparently immunocompetent. Disseminated disease and cryptococcal meningitis were present in four patients each. Most patients received amphotericin B plus fluconazole. Seven out of the 11 patients cured and four died before or during the therapy. The increased number of individuals with cryptococcosis by this species during the last decades needs to be carefully evaluated specially those who are HIV-infected. Nevertheless,
Cryptococcus
species differentiation is currently relevant in order to better know their relation with geographical, clinical host preference and outcome particularities. |
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ISSN: | 0301-486X 1573-0832 |
DOI: | 10.1007/s11046-018-0304-3 |