Cryptococcosis
Contents:
Description:
Cryptococcosis (synonyms: торулез, European zymonematosis; Kryptokokkose - is mute.; cryptococcose - fr.; criptococcosis - исп.) - subacutely or chronically proceeding deep mycosis which is characterized by a heavy current with preferential damage of the central nervous system is more rare than lungs, skin and mucous membranes.
Infection atriums in most cases are upper respiratory tracts and lungs, primary cryptococcosis of skin, perhaps endogenous development of an infection in healthy carriers at decrease is less often observed at them a host defense (HIV-positive people, etc.). The disease to a bowl occurs at persons of 40-60 years, men are ill more often, quite often the cryptococcosis developed at patients with a lymphogranulomatosis that is caused by also developing immunodeficiency.
Cryptococcosis symptoms:
Duration of an incubation interval is not established. The most characteristic manifestation of a cryptococcosis is the encephalomeningitis. Described it and under the name of torulezny meningitis. The disease is characterized by the gradual, hardly noticeable beginning in the form of headache attacks, a thicket in frontal area which gradually amplify, become intolerable, move to the occipital area. There are meningeal signs, a ptosis, a nystagmus, a hemiplegia. Consciousness is broken, nonsense. Characteristic of a disease at serious condition body temperature remains subfebrile. The disease which is slowly progressing, leading to exhaustion, then coma death comes from breath paralysis in 4-6 months from an onset of the illness. At 30% of patients, except damage of the central nervous system, the cryptococcosis of lungs develops.
The cryptococcosis of lungs proceeds in the form of pneumonia, it is not enough what other etiology, different from pneumonia, body temperature is more often subfebrile, the phlegm scanty, process is more often bilateral. At the disseminated form of a cryptococcosis the most various bodies can be surprised (a liver, kidneys, a spleen, etc.). Damages of skin and mucous membranes proceed rather easily.
At HIV-positive people the cryptococcosis proceeds almost only in the form of heavy meningitis and an encephalomeningitis.
Cryptococcosis reasons:
The activator - Cryptococcus neoformans. In pathological material has an appearance of the yeast cells of rounded shape with a diameter of 3-10 microns surrounded with the transparent zhelatinoobrazny capsule up to 50 microns wide. Does not form a mycelium. Patogenen for laboratory animals (white mice, rats). It is steady in external environment.
The cryptococcus is eurysynusic in the nature, it is found in a dung of pigeons, sparrows and other birds, at the same time birds are not ill. In the dried-up state the cryptococcus can remain within many months. The cryptococcus was found on mucous membranes of healthy people as a saprophyte. Infection of the person happens in the air and dust way.
Treatment of the Cryptococcosis:
Sick cryptococcosis usually appoint intravenously Amphotericinum In (0,6 — 0,8 mg/kg/days), as in a combination with ftortsitoziny (no more than 150 mg/kg/days), and without it. Then gradually pass on флуконазол which is appointed inside (on 400 mg/days, with transition to 200 mg/days) within 6 — 10 weeks.
