Navegando por Assunto "Meningite criptocócica"

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Avaliação audiomética em pacientes tratados de meningite por Cryptococcus gattii
(Universidade Federal do Pará, 2007) ALVES, Rogério Benjamim Francisco; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539
This study shows the audiometric evaluation, composed by tonal audiometry and imitanciometry, in patients treated for Cryptococcus gattii meningitis. It was analyzed six patients with proven Cryptococcus gattii central nervous system infection, interned in the Hospital Universitário João de Barros Barreto, Belém, PA, Brazil, between January of 2000 and November of 2007, for antifungal treatment. The age of the analyzed patients ranged from 12 to 37 years-old. Three were men and three women. All of them originating from neighboring cities, nobody from the capital, Belém. The most common clinical findings were headache and vomiting, present in all the patients; fever and nuchal rigidity, each one absent in only one patient, not coincidents. The time of illness until the diagnosis varied from 3 to 8 weeks. Of the three evaluated men, hearing loss was presenting in two. In one of them deafness was moderate and unilateral and in the other it was bilateral and not symmetrical. Of the three women, only one presented hearing impairment. In this patient, occurred just a mild alteration in an isolated frequency, of 4.000 Hz. It is described audiometric findings in a relate of cases of patients treated for meningeal neurocryptococcosis due to Cryptococcus gattii.
Acesso aberto (Open Access)
Fatores prognósticos de letalidade na meningoencefalite criptocócica em crianças e adolescentes no estado do Pará
(Universidade Federal do Pará, 2016) CARNEIRO, Rose Sheyla Rodrigues; SOUSA, Rita Catarina Medeiros; http://lattes.cnpq.br/3560941703812539; RODRIGUES, Anderson Raiol; http://lattes.cnpq.br/4030747999301402
Introduction: Cryptococcosis is a systemic fungal infection that often affects adults, especially those who have an alteration in their cellular immunity. Its frequency in children is low. Objective: to describe the clinical, epidemiological, radiological and laboratorial profile of children with meningitis cryptococcal, and to evaluate what are the circumstances that affect the evolution of these patients and increase the fatality rates of the disease. Materials and methods: we performed a retrospective review of medical records in which we evaluated the prognostic factors of 62 children less than 16 years old, diagnosed with cryptococcal meningoencephalitis, admitted in the at João de Barros Barreto Hospital, reference for patients with infectious diseases in Belém-PA, from 1999-2013. Results: Ages ranged from less than 4 to 15 years. The average age was 10 and 66% were male. The Para state microregions, presented by order of decreasing frequency, showed: Cametá (29%), Guamá (12,9%), Belém (12,9%), Tomé-Açu (11,3%), Bragantina (9,7%) and others (39%). The predominant clinical presentation was the subacute form, represented by 50% of the cases. The most frequent clinical manifestations were headache (98,4%), fever (91,9%) and vomiting (88,7%). A skull tomography was performed in 54 patients, and abnormalities were reported in 43 (79,6%). Hydrocephalus was described in 27 cases. Cryptococcus gattii was the main agent involved, identified in 35 children (71,4%). In total, 91,9% of the patients were treated with amphotecicin B (AmB) alone. Conclusions: Rate of lethality from 19,3%; Seizure was a prognostic factor of lethality. In the State of Pará, where cryptococcosis by Cryptococcus gattii is endemic, the disease in children is relatively frequent. However, studies in this population are still scarce and there are no own management guides. New studies are needed to improve the management of children by this fungal infection.
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Investigação de danos visuais em pacientes diagnosticados com meningite criptocócica não associada à imunossupressão
(Universidade Federal do Pará, 2014-03-20) LACERDA, Eliza Maria da Costa Brito; SOUZA, Givago da Silva; http://lattes.cnpq.br/5705421011644718; SILVEIRA, Luiz Carlos de Lima; http://lattes.cnpq.br/9383834641490219
Cryptococcal meningitis is a severe infectious disease caused by Cryptococcus spp., which has high lethality and causes sensorial sequels. The most important sequels are visual impairments. The aim of this study was to describe the visual losses suffered by patients without immunosupression history, diagnosed with cryptococcal meningitis in order to indicate a possible mechanism and risk factors for the visual sequels. The work was composed by a case series study with cryptococcal meningitis without immunosupression history (n =7 patients, 14 = eyes) and an epidemiological study of all the cases of cryptococcal meningitis without immunosupression history notified during 14 years in the reference hospital of Para State (n = 113 cases). In the case series study, the visual functions of a sample of patients were studied by ophthalmological, psychophysical, and electrophysiological evaluation. The epidemiological study analyzed the medical records data focusing on visual impairment. It was observed that the studied patients in the case series study had visual acuity impairment. Even in patients without clinical complaints, color discrimination, luminance contrast sensitivity, and visual field were impaired. The results indicated central retina commitment as the principal responsible for a cascade of alterations that prevented the normal upstream image processing, at the visual cortex level. It is suggested that the observed visual dysfunction was due not only to optic nerve damage. The principal risk factors for the visual alterations observed in the epidemiological study were disease time before the beginning of the treatment and patient immunological response.
Acesso aberto (Open Access)
Neurocriptococose pediátrica no Estado do Pará: espectro de achados tomográficos na infecção por Cryptococcus neoformans var. gattii
(Universidade Federal do Pará, 2001-09-05) CORRÊA, Maria do Perpétuo Socorro Costa; MAGALHÃES, Luiz Marconi Fortes; http://lattes.cnpq.br/6032076996211936; SEVERO, Luiz Carlos; http://lattes.cnpq.br/8729316807859951
This study shows the spectrum of computed tomography (CT) findings in children's neurocryptococcosis due to Cryptococcus neoformans var. gatfii, in the State of Para. We analysed the cranial CT scan appearance of eleven children (younger than 13 years of age) with proven central nervous Cryptococcus neoformans var. gattii infection, between January 1992 and December 2000, who were horizontalized were referred to Hospital universitário João de Barros Barreto, Belém, PA, Brazil. Intracranial cryptococcosis was defined by identification of encapsulated yeast by microscopic examination and isolation of Cryptococcus neoforman from cerebrospinal fluid and positive identification of the var. gattii with use of canavanine-glycine-bromothymol blue agar media, with at least a cranial CT study obtained at the time of the diagnosis. The age range was 6 years to 12 years, with a mean age of 8,8 years. Six were girls and five were boys. The most common clinical findings were headache, fever and nuchal rigidity (n=11 ); nausea and vomiting (n=10). The mean time from onset of symptoms to diagnosis was 4.2 weeks (range, 2 to 8 weeks). No normal cranial CT was detected in any patient. In all patients were observed hypodense nodules. The remaning scan abnomalities were as follows: six had hydrocephalus, nine had diffuse atrophy, and five had hydrocephalus coexistant with diffuse atrophy. We described by the first time cranial CT scan findings in series of case of neurocryptococcosis due Cryptococcus neoformans var. gaftii in immunocompetent children. This study shows that this infection most commonly develops multiple hypodense nodules, mainly in the basal ganglia region and in the cerebral white matter. These lesions apparently progress to important atrophy of the cerebral white matter, with ventricular dilatation and prominence of cerebral sulci, consequent of a presumable compensatory hydrocephalus. In general, these patients present mild changes in cerebral cortex.