Laboratório de Micologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goias, Goiânia, GO, Brazil.
Rev Soc Bras Med Trop. 2013 May-Jun;46(3):343-7. doi: 10.1590/0037-8682-0061-2012.
In this study, the clinical features, underlying diseases and clinical outcomes of patients with cryptococcosis were investigated. In addition, a molecular analysis of the Cryptococcus neoformans species complex isolated from these patients was performed.
A prospective study of 62 cases of patients with cryptococcal infection was conducted at the Hospital de Doenças Tropicais de Goiás Dr. Anuar Auad from 2009-2010. Cryptococcal meningitis cases were diagnosed by direct examination and cerebrospinal fluid (CSF) sample culture. The profiling of these patients was assessed. The CSF samples were submitted to India ink preparation and cultured on Sabouraud dextrose agar, and C. neoformans was identified by the production of urease, a positive phenoloxidase test and assimilation of carbohydrates. C. neoformans and C. gattii isolates were distinguished by growth on L-canavanine-glycine-bromothymol blue medium, and molecular analysis was conducted via PCR fingerprinting reactions using M13 and (GACA)4 primers.
From the 62 patients with cryptococcosis, 71 isolates of CSF were obtained; 67 (94.4%) isolates were identified as C. neoformans var. grubii/VNI, and 4 (5.6%) were identified as C. gattii/VGII. Of these patients, 53 had an HIV diagnosis. The incidence of cryptococcosis was higher among patients 20-40 years of age, with 74.2% of the cases reported in males. Cryptococcus-related mortality was noted in 48.4% of the patients, and the symptoms were altered sensorium, headache, fever and stiff neck.
The high morbidity and mortality observed among patients with cryptococcosis demonstrate the importance of obtaining information regarding the epidemiological profile and clinical course of the disease in the State of Goiás, Brazil.
本研究旨在调查隐球菌病患者的临床特征、基础疾病和临床转归。此外，还对从这些患者中分离出的新型隐球菌种复合体进行了分子分析。
对 2009 年至 2010 年期间在戈亚斯热带病医院诊断为隐球菌感染的 62 例患者进行了前瞻性研究。隐球菌性脑膜炎病例通过直接检查和脑脊液（CSF）样本培养进行诊断。评估了这些患者的病情。CSF 样本进行印度墨水准备和沙氏葡萄糖琼脂培养，通过产生脲酶、阳性酚氧化酶试验和碳水化合物同化来鉴定新型隐球菌。通过在 L--canavanine-glycine-bromothymol blue 培养基上的生长来区分新型隐球菌和 C. gattii 分离株，并通过使用 M13 和 (GACA)4 引物的 PCR 指纹反应进行分子分析。
从 62 例隐球菌病患者中获得了 67 例（94.4%）CSF 分离株，其中 67 例（94.4%）被鉴定为新型隐球菌 var. grubii/VNI，4 例（5.6%）被鉴定为 C. gattii/VGII。这些患者中有 53 例 HIV 诊断。20-40 岁的患者中隐球菌病发病率较高，其中 74.2%为男性。48.4%的患者发生与隐球菌相关的死亡，症状为意识改变、头痛、发热和颈部僵硬。
隐球菌病患者的高发病率和死亡率表明，在巴西戈亚斯州获得有关疾病的流行病学特征和临床过程的信息非常重要。
