Abstract：
BACKGROUND: Cryptococcosis is still a life-threatening mycosis that continues to be of serious concern in Latin American countries, especially among HIV+positive population. However, there is not any reliable information about the prevalence of this disease in this region.
OBJECTIVE: The aim of this study is to report data of 2041 patients with cryptococcosis that were attended at the Infectious Diseases Hospital F. J. Muñiz over a 30 year-period.
METHODS: Information about demographic and clinical data, survival time and the applied treatment, was taken from the Mycology Unit database. Mycological exams from different clinical samples were performed. Cryptococcal capsular antigen in serum and cerebrospinal fluid was detected through the latex agglutination technique. Cryptococcus isolates were phenotypically identified and the genotype was determined in some of them. Susceptibility tests were carried out following M27-A3 document.
RESULTS: Seventy five percent of HIV+positive patients and 50% of the HIV-negative population were males. Mean ages were 34.1 in HIV+positive patients and 44.8 in the HIV-negative. Cryptococcosis was associated with AIDS in 98% of the cases. Meningeal compromise was seen in 90% of the patients. Although cerebrospinal fluid rendered more positive results, blood culture was the first diagnostic finding in some cases. Cryptococcal antigen showed positive results in 96.2% of the sera samples and in the 93.1% of the cerebrospinal fluid samples. Most of the isolates were Cryptococcus neoformans and belonged to genotype VNI. Minimal inhibitory concentration values were mostly below the epidemiological cutoff values.
CONCLUSIONS: We observed that thanks to a high level of clinical suspicion, early diagnosis, combined therapy and intracranial pressure control by daily lumbar punctures, the global mortality rate has markedly decreased through the years in the analyzed period.
OBJECTIVE: The aim of this study is to report data of 2041 patients with cryptococcosis that were attended at the Infectious Diseases Hospital F. J. Muñiz over a 30 year-period.
METHODS: Information about demographic and clinical data, survival time and the applied treatment, was taken from the Mycology Unit database. Mycological exams from different clinical samples were performed. Cryptococcal capsular antigen in serum and cerebrospinal fluid was detected through the latex agglutination technique. Cryptococcus isolates were phenotypically identified and the genotype was determined in some of them. Susceptibility tests were carried out following M27-A3 document.
RESULTS: Seventy five percent of HIV+positive patients and 50% of the HIV-negative population were males. Mean ages were 34.1 in HIV+positive patients and 44.8 in the HIV-negative. Cryptococcosis was associated with AIDS in 98% of the cases. Meningeal compromise was seen in 90% of the patients. Although cerebrospinal fluid rendered more positive results, blood culture was the first diagnostic finding in some cases. Cryptococcal antigen showed positive results in 96.2% of the sera samples and in the 93.1% of the cerebrospinal fluid samples. Most of the isolates were Cryptococcus neoformans and belonged to genotype VNI. Minimal inhibitory concentration values were mostly below the epidemiological cutoff values.
CONCLUSIONS: We observed that thanks to a high level of clinical suspicion, early diagnosis, combined therapy and intracranial pressure control by daily lumbar punctures, the global mortality rate has markedly decreased through the years in the analyzed period.
摘要：
背景：隐球菌病仍然是一种威胁生命的真菌病，在拉丁美洲国家仍然受到严重关注，特别是在艾滋病毒阳性人群中。然而,该地区没有关于这种疾病患病率的任何可靠信息。
目的：本研究的目的是报告在传染病医院F.J.Muñiz治疗30年的2041例隐球菌病患者的数据。
方法：有关人口统计学和临床数据的信息，生存时间和应用的治疗，取自真菌学组数据库.进行来自不同临床样品的真菌学检查。通过乳胶凝集技术检测血清和脑脊液中的隐球菌荚膜抗原。对隐球菌分离株进行了表型鉴定，并确定了其中一些的基因型。在M27-A3文件之后进行敏感性测试。
结果：75%的HIV阳性患者和50%的HIV阴性人群是男性。HIV阳性患者的平均年龄为34.1，HIV阴性患者的平均年龄为44.8。在98％的病例中，隐球菌病与艾滋病有关。90％的患者出现脑膜损害。虽然脑脊液提供了更积极的结果，在某些情况下，血培养是第一个诊断结果。隐球菌抗原在96.2%的血清样本和93.1%的脑脊液样本中显示阳性结果。大多数分离株是新生隐球菌，属于基因型VNI。最小抑制浓度值大多低于流行病学临界值。
结论：我们观察到，由于高度的临床怀疑，早期诊断,通过每日腰椎穿刺联合治疗和颅内压控制，在分析期间的几年中，全球死亡率显着下降。
目的：本研究的目的是报告在传染病医院F.J.Muñiz治疗30年的2041例隐球菌病患者的数据。
方法：有关人口统计学和临床数据的信息，生存时间和应用的治疗，取自真菌学组数据库.进行来自不同临床样品的真菌学检查。通过乳胶凝集技术检测血清和脑脊液中的隐球菌荚膜抗原。对隐球菌分离株进行了表型鉴定，并确定了其中一些的基因型。在M27-A3文件之后进行敏感性测试。
结果：75%的HIV阳性患者和50%的HIV阴性人群是男性。HIV阳性患者的平均年龄为34.1，HIV阴性患者的平均年龄为44.8。在98％的病例中，隐球菌病与艾滋病有关。90％的患者出现脑膜损害。虽然脑脊液提供了更积极的结果，在某些情况下，血培养是第一个诊断结果。隐球菌抗原在96.2%的血清样本和93.1%的脑脊液样本中显示阳性结果。大多数分离株是新生隐球菌，属于基因型VNI。最小抑制浓度值大多低于流行病学临界值。
结论：我们观察到，由于高度的临床怀疑，早期诊断,通过每日腰椎穿刺联合治疗和颅内压控制，在分析期间的几年中，全球死亡率显着下降。
