Universidade Federal de Pelotas, Instituto de Biologia, Departamento de Microbiologia e Parasitologia, Laboratório de Micologia. Programa de Pós-Graduação em Microbiologia e Parasitologia, Pelotas, RS, Brazil.
Universidade Federal de Santa Maria, Centro de Ciências da Saúde, Programa de Pós-graduação em Ciências Farmacêuticas (PPGCF), Santa Maria, RS, Brazil.
Med Mycol. 2023 Feb 3;61(2). doi: 10.1093/mmy/myad016.
Cryptococcosis is a fungal disease of public health relevance that affects numerous animal species and humans, causing respiratory and neurological impairment. Hence, we conducted a systematic review that included publications from 1975 to 2021 and covered 132 articles that addressed reports of cryptococcosis in domestic and wild animals, its main clinical manifestations, pathological findings, etiology, diagnosis, and therapeutic protocols. We found that the highest number of reports of cryptococcosis is in domestic species, especially cats. Among the wild and/or exotic animals, koalas and ferrets are the most affected, being important carriers of Cryptococcus spp. Pulmonary and neurological involvement is predominant in all species, although nonspecific clinical manifestations have been reported in various species, making clinical suspicion and diagnosis difficult. The countries with the most reports are Australia, the United States, Brazil, and Canada, with C. gattii VGI and VGII standing out. The therapies were based on azoles, amphotericin B, and 5-flucytosine, although there is no standard treatment protocol. Although, several diagnostic methods have been described, in a significant number of reports the diagnosis was made after a necropsy. Professionals are warned about diverse and nonspecific clinical manifestations in different animal species, which underlines the importance of cryptococcosis in the differential diagnosis in clinical practice. Furthermore, it is necessary to encourage the use of laboratory and molecular tools to improve the diagnosis of cryptococcosis. We also emphasize the urgent need for standardized therapeutic protocols to guide veterinary clinicians.
隐球菌病是一种具有公共卫生相关性的真菌病，影响众多动物物种和人类，导致呼吸道和神经系统损伤。因此，我们进行了一项系统评价，其中包括 1975 年至 2021 年的出版物，并涵盖了 132 篇文章，这些文章涉及隐球菌病在 domestic 和野生动物中的报告、其主要临床表现、病理发现、病因、诊断和治疗方案。我们发现，隐球菌病报告数量最多的是 domestic 物种，尤其是猫。在野生动物和/或外来动物中，考拉和雪貂受影响最严重，是隐球菌属的重要携带者。所有物种都以肺部和神经系统受累为主，尽管在不同物种中报告了非特异性临床表现，这使得临床怀疑和诊断变得困难。报告数量最多的国家是澳大利亚、美国、巴西和加拿大，其中 C. gattii VGI 和 VGII 较为突出。治疗方法基于唑类、两性霉素 B 和 5-氟胞嘧啶，尽管没有标准的治疗方案。尽管已经描述了几种诊断方法，但在相当多的报告中，诊断是在尸检后做出的。专业人员被警告注意不同动物物种中多样且非特异性的临床表现，这突显了隐球菌病在临床实践中鉴别诊断中的重要性。此外，有必要鼓励使用实验室和分子工具来改善隐球菌病的诊断。我们还强调迫切需要标准化的治疗方案来指导兽医临床医生。
