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CryptococcosisCryptococcosis General InformationThe infection known as Cryptococcosis is caused by the fungus C. neoformans. This fungus is found all around the world. It can be located in soil that contains bird droppings or on unwashed raw fruits. You might be more familiar to the other names of this medical condition: European blastomycosis, cryptococcal meningitis, torulosis, Busse-Buschke disease, or torular meningitis. The disease was rare until a few years ago when the AIDS epidemic started. Very sensitive to Cryptococcosis are those people who follow a long-term therapy based on drugs that suppress the immune system, such as chemo drugs or corticosteroids, those who have sarcoidosis, Hodgkin’s disease or other lymphomas. For them, this fungal infection can be really life-threatening. In healthy individuals, this illness is less common. This disorder usually attacks the meninges (the tissues that cover the spinal cord and the brain), provoking meningitis (an inflammation of these membranes that is very fatal), the skin and the lungs, but some other organs may also be involved because this disease spreads very frequently. A person gets infected with the Cryptococcus neoformans by inhaling it. In the past 15 years the prevalence of this infection has been increasing for numerous reasons, and one of them is the increased incidence of patients who use immunosuppressive drugs and of patients who are suffering from AIDS. The infections caused by fungus in humans can be divided in three categories: cryptococcal meningitis, cutaneous or wound Cryptococcosis and cryptococcal pulmonary. Many studies showed that an infection of this kind is more dangerous for men than for women. The average age of sick patients is around 45 years old. Cryptococcosis SymptomsAfter the fungus enters the body and reaches the lungs, the immune system can heal the organism without any medical treatment. Thanks to the normal functioning of the immune system the person will not develop any symptoms or complications and he or she can not infect any healthy individuals. But these cases of asymptomatic patients are generally rare because in many cases the immune system is not very strong and it enables the disorder to remain in the lungs or to spread throughout the body. Specialists use to say about Cryptococcosis that is an opportunistic disease. More than 5% of the patients with AIDS get this fungal infection. In case the microorganism is not killed by the body, it will grow and form nodules in the lungs (these nodules can only be seen on X-rays of the chest areas). The early stages of this affection are characterized by symptoms similar to those of any other respiratory infection, for example a dry cough. This is mainly the cause why Cryptococcosis is not always diagnosed in time, fact that allows various complications to develop. The most common symptoms and signs, specific for this health disorder are: pain felt in the abdominal area or in the chest, tiredness, headache, abdominal fullness felt prematurely after eating, swollen abdomen, nausea and vomiting, loss of the appetite, excessive and unusual sweating over the night, weakness, pain felt along the path of a nerve, bleeding, weight loss, tingling and numbness, confusion, ecchymoses (bruises), petechiae (skin rashes, pinpoint red marks), swollen glands, fever, pain, diplopia (double, blurred vision), dizziness, abnormal gait, tenderness of the sternum (bone of the breast), encephalitis and irritability. Cryptococcosis TreatmentYou should contact your health care provider as soon as you notice the symptoms specific for Cryptococcosis, especially if you know you have a weak or damaged immune system. It is very important to do this step because if complications appear, this disease represents a real threat for your life. If it is not discovered in time it can lead to complications, such as meningitis, side effects of the drugs, relapses of the infection and permanent damage to the brain and nerves. Those specialists who interact very often with patients with AIDS are more experienced in diagnosing this disorder. The test to determine if a person has Cryptococcosis is very simple and consists in a sample of the CSF (cerebrospinal fluid) and blood that will be examined to see if there is an antigen that is produced by C. neoformans. The sample of CSF is taken during a lumbar puncture from the space between the spinal cord and the vertebrae. After the liquid is withdrawn, India ink is added to observe the presence of the fungus. If it exists, the ink will cover the edges of the fungus or will bind to the capsule. This test is done especially when the patient is asymptomatic, has advanced AIDS and he or she was exposed to the fungus. Other ways of testing for Cryptococcosis: isolation of the fungus in cultures of CSF, bronchoscopy, cultures of sputum or biopsy of the lung’s tissues. Before proceeding with any treatment it is very important to see how damaged the lungs are. Very useful in this matter are the X-rays of the chest. Urine can also provide a significant result before giving the final diagnosis. If the infection is heavy, the cultures of blood may be positive. Cryptococcosis is usually treated with amphotericin B (desoxycholate) because this is the only medicine that produces a benefic response. Since this drug was discovered, the survival rate reached even to 85-90%. Before this medicine had appeared on market, very few survivors to Cryptococcosis were reported all over the world. Other effective medicines that have decreased the mortality rate are the azoles, flucytosine and Fluconazole. In combination with the last one, amphotericin B is even more effective. All these drugs are used only in persons with a damaged immune system because in those who benefit from a healthy organism, the disease cures itself. Amphotericin B is known to be a very strong drug against fungal infections, although it presents many potentially toxic side effects. For example, the concentration of hemoglobin in the blood may decrease and kidney toxicity may appear. When using this medicine, some patients may accuse fever, nausea and vomiting, muscle aches, chills, headache and diarrhea. This therapy is administrated for 15 or 30 days. |
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