Cryptococcosis

Cryptococcosis - subacutely or chronically proceeding deep mycosis characterised by serious flow with a primary lesion of the central excitatory system, is rarer lungs, a skin and mucosas.

Aetiology. The originator - Cryptococcus neoformans. In a pathological stuff 3-10 microns surrounded transparent gelatin with a figurative capsule in width to 50 microns look like the yeast cells of the roundish form in diameter. A mycelium does not form. It is pathogenic for laboratory animals (white mice, rats). It is steady in an external environment.

Epidemiology. A cryptococcus eurysynusic in the nature, it find in a dung of pigeons, sparrows and other auks, thus auks are not ill. In the dryed up condition the cryptococcus can remain within many months. A cryptococcus found on mucosas of healthy humans as a saprophyte. The becoming infected of the human descends air-dust by.

Pathogenesis. Infection atriums in most cases are the top respiratory tracts and lungs, the primary cryptococcosis of a skin, probably endogenous development of an infection contamination in healthy carriers is less often observed at depression at them a host defence (a HIV-infected, etc.). Disease met at persons of 40-60 years is more often, men were ill more often, quite often the cryptococcosis educed at sick of a lymphogranulomatosis that is caused also by an educing immunodeficiencyy.

Symptoms and flow. Duration of an incubation interval is not established. The most typical implication of a cryptococcosis is the meningocephalitis. Described it and under the name torulosa a meningitis. Disease is characterised by the gradual, hardly noticeable beginning in the form of headache attacks, more often in frontal range which gradually strengthen, become intolerable, move to occipital range. There are meningeal signs, a ptosis, a nystagmus, a hemiplegia. The consciousness is broken, delirium. Prominent feature: at a grave condition the body temperature remains subfebrile. Disease slowly progressing, conducting to attrition, then a coma, mors comes from a breath paralysis in 4-6 months from the illness beginning. At 30 % of patients, except a lesion of the central excitatory system, the cryptococcosis of lungs educes.

The cryptococcosis of lungs proceeds in the form of a pneumonia, the body temperature more often subfebrile, a sputum poor, process more often the bilaterial is not enough than other aetiology differing from a pneumonia. At the disseminated form of a cryptococcosis the most various organs (a liver, nephroses, a lien, etc.) can be amazed. Lesions of a skin and mucosas proceed rather easily.

At a HIV-infected the cryptococcosis proceeds almost exclusively in the form of a serious meningitis and a meningocephalitis.

The diagnosis and the differential diagnosis. Clinically it is necessary to differentiate from a tubercular meningitis, neoplasms and a brain abscess. As acknowledgement cryptococcus detection serves.

The forecast. At the meningeal form and a disseminated cryptococcosis the forecast bad. At a lesion of a skin and mucosas the congenial. Treatment by Amphotericinum In enriches the forecast.

Preventive maintenance is not developed.