Diagnóstico e tratamento da criptococose do sistema nervoso central: considerações sobre 16 casos

• Autor(a) principal: Spina-frança, A.
• Data de Publicação: 1968
• Outros Autores: Silva, Jeová B. Da [UNESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://dx.doi.org/10.1590/S0004-282X1968000200003; http://hdl.handle.net/11449/211053

Sixteen cases of cryptococcosis of the central nervous system diagnosed at Hospital das Clínicas of São Paulo University Medical School between 1951 and 1966 were reviewed. The diagnoses were based on the appearance of C. neoformansin cerebrospinal fluid (CSF) examination and/or autopsy findings. The study was made to point out the importance of early diagnosis in the treatment by amphotericin-B. Of the four patients treated with this medicine, two deceased. In these two cases the diagnosis was made when the disease was in the final stage. Of the two cases diagnosed and treated in early stages the results was favorable. The clinical history of the cases is reported. The other twelve patients were treated with different medications and all expired. In order to point out the main clinical and laboratory data that may suggest the disease the cases were reviewed. The revision enabled the authors to point out the importance of the dissociation between the pronounced intracranial hypertensive symptoms and those of meningoencephalitis. The authors call attention to the CSF changes, which may be confused with those found in other types of meningoencephalitis, especially the tuberculous one. The confusion is frequently avoided when C. neoformansis searched through the direct exam (especially using the China ink process). This examination enabled one to find the yeasts in the majority of the cases: in nine out of eleven of the reported cases C. neoformanswas demonstrated by direct examination.