Criptococosis pulmonar y meníngea, en paciente inmunocompetente / Pulmonary and meningeal Cryptococcosis in an immunocompetent patient

La criptococosis es una enfermedad micótica oportunista, grave, causada por Cryptococcus neoformans. un hongo levaduriforme y encapsulado. Sus dos variedades; Cryptococcus neoformans variedad. neoformans (serotipos A y D) y Cryptococcus neoformans variedad. gattii (serotipos B y C) son responsables de enfermedad en el hombre. La infección ocurre por inhalación del microorganismo presente en el excremento principalmente de las palomas. Produce una infección pulmonar inicial desde donde se disemina a otros órganos sobre todo meninges y sistema nervioso central causando una meningoencefalitis; puede diseminarse a piel y vísceras. La criptococosis afecta con mayor frecuencia a personas inmunosuprimidas, en especial pacientes con SIDA. Presentamos el caso de una mujer de 40 años edad, sin antecedentes personales conocidos, a quien no se le conoce ningún estado de inmunosupresion, con serologías negativas para HIV; consultó al servicio de emergencia del Hospital General del Este, Dr Domingo Luciani, en la ciudad de Caracas, Venezuela. por clínica respiratoria de un mes de evolución, tos seca, cefalea, náuseas y vómitos. En el estudio radiológico de tórax se observó una imagen homogénea, radiopaca, que ocupaba el lóbulo superior de pulmón izquierdo. se le realizó fibrobroncoscopia con biopsia y lavado bronquial y los con hallazgos fueron sugestivos de criptococosis pulmonar. Además se realiza punción lumbar por sintomatología neurológíca, con reporte de criptolatex y tinta china positivo en LCR, demostrando el compromiso neurológico. Se planteó una criptococosis pulmonar con compromiso meníngeo(AU)

Cryptococcosis is a serious opportunistic fungal disease caused by Cryptococcus neoformans . There are two varieties; Cryptococcus neoformans var. neoformans (serotypes A and D) and Cryptococcus neoformans var. gattii (serotypes B and C) and they are responsible for human disease. Infection occurs by inhalation of microorganisms present in the feces mainly of pigeons. An initial pulmonary infection occurs and then it can spreads to other organs especially meninges and central nervous system causing meningoencephalitis; also to skin and vísceras. Cryptococcosis most often affects immunosuppressed people, especially AIDS patients. We present the case of a 40 year-old woman who consulted to the Emergency Service of the Hospital Dr Domingo Luciani, in Caracas, Venezuela. She had respiratory symptoms for a month as well as nausea and vomits; The chest radiograph showed a radiopaque homogeneous image in the left upper lobe of the lung. A bronchoscopy plus biopsy and washing was suggestive of pulmonary cryptococcosis . Because some neurological symptoms were present, a lumbar punction was performed and criptolatex reported positive in the CSF, diagnosing a disseminated cryptococcosis with meningeal involvement(AU)

The Role and Operating System of Korean Collection of Medical Fungi (KCMF) / 대한의진균학회지

In general, fungi including yeast and filamentous form, locate in soil, water, plant, animal and human. Fungi can be survived almost in every environmental conditions and be useful or harmful for humans. Some human pathogenic fungi may infection immunocompromised peoples and/or susceptible hosts causing hypersensitivity disease, mycotoxicoses, which can be induced by mycotoxins, and mycoses. Mycoses are classified into four classes, such as superficial and/or cutaneous mycoses, subcutaneous mycoses, opportunistic mycoses, and systemic or deep seated mycoses. Recently, due to the increasement of immune system defective patients which are usually caused by HIV infection, transplant and cancer, opportunistic systemic fungal infection has been dramatically elevated. Fast diagnose system and early antifungal treatments are required because the morbidity and mortality of these systemic infections are very high. Although these opportunistic infections caused by mainly Candida, Aspergillus and Cryptococcus spp. are getting higher, no culture collection and/or strain bank for the infectious fungal strains are operated in Korea. These situations allows us to establish a novel Korean collection of medical fungi (KCMF) for their genetic materials. KCMF will be a hub for human pathogenic fungal strains isolated in Korea and will serve to studies of clinical and basic mycological research as well as to maintain various mutants and varieties which could be useful for develop new antifungal agents and drug discovery. The successful Korean Collection of Medical Fungi (KCMF) will contribute to; 1. Create informative world-wide culture collection of clinically isolated fungal strains. 2. Obtain various medical mycological materials as well as antifungal agent resistant strains for studying fungi-related topics including novel antifungal agents. 3. Create world-wide network for the researchers who study medical mycology and provide workshop and various information for the fungal community. The purpose of establish a novel Korean collection of medical fungi(KCMF) is to isolate, classify, and collect human pathogenic fungal strains, isolated from human clinical specimens from superficial and systemic infections. Furthermore, maintaining a culture collection for Korean specific clinical isolates and resistant strains of antifungal agents.