{"id":6610,"date":"2020-04-22T10:54:10","date_gmt":"2020-04-22T13:54:10","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/criptococosis\/"},"modified":"2020-04-27T17:15:21","modified_gmt":"2020-04-27T20:15:21","slug":"cryptococcosis-2","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/criptococosis\/","title":{"rendered":"Cryptococcosis"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/criptococosis\/#%C2%BFQue-es-la-criptococosis\" >What is cryptococcosis?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/criptococosis\/#%C2%BFCuales-son-las-causas-y-los-factores-de-riesgo-para-la-criptococosis\" >What are the causes and risk factors for cryptococcosis?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/criptococosis\/#%C2%BFCuales-son-las-caracteristicas-clinicas-de-la-criptococosis\" >What are the clinical features of cryptococcosis?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/criptococosis\/#Infeccion-criptococica-de-la-piel\" >Cryptococcal infection of the skin<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/criptococosis\/#%C2%BFComo-se-diagnostica-la-criptococosis\" >How is cryptococcosis diagnosed?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/criptococosis\/#%C2%BFCual-es-el-tratamiento-para-la-criptococosis\" >What is the treatment for cryptococcosis?<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-es-la-criptococosis\"><\/span>What is cryptococcosis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Cryptococcosis is a fungus <span class=\"term\" data-term-id=\"145\">infection<\/span> caused by inhaling the fungus <em>Cryptococcus neoformans<\/em>, which is mainly found in soils enriched with pigeon droppings. In the fall of wet or dried pigeons, <em>C. neoformans<\/em> it can remain viable for 2 years or more.<\/p>\n<p>Two varieties of <em>C. neoformans<\/em> exist - neoformans and gattii. <em>C. neoformans<\/em> var <em>neoformans<\/em> is the most common variety and mainly affects <span class=\"term\" data-term-id=\"1699\">immunosuppressed<\/span> patients such as those with human immunodeficiency virus (<span class=\"term\" data-term-id=\"127\">HIV<\/span>) infection and AIDS. <em>C. neoformans<\/em> var <em>gattii<\/em> it is much less common, but mainly affects immunocompetent people. This variety is restricted to subtropical and tropical areas and the fungus is found in eucalyptus trees and in the surrounding air.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-las-causas-y-los-factores-de-riesgo-para-la-criptococosis\"><\/span>What are the causes and risk factors for cryptococcosis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The most common cryptococcosis infections (<em>C. neoformans<\/em> var <em>neoformans<\/em>) affect people with immunodeficiency, for example, patients with high doses of corticosteroids, <span class=\"term\" data-term-id=\"30\">Cancer<\/span> <span class=\"term\" data-term-id=\"1619\">chemotherapy<\/span> patients organ <span class=\"term\" data-term-id=\"1793\">transplant<\/span> patients and patients with acquired immunodeficiency (AIDS) and HIV infection. With the global rise of AIDS, cryptococcosis is now one of the most common life-threatening fungal infections in these patients.<\/p>\n<p>The infection is mainly through <span class=\"term\" data-term-id=\"1355\">inhalation<\/span> of cryptococcus spores released from soil and bird droppings. It occurs in both humans and animals, but animal-to-human and human-to-human transmission through respiratory droplets has not been documented. Transmission by organ transplantation has been reported when organs from infected donors were used. Infection from cuts through the skin is not common, but it can occur.<\/p>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-las-caracteristicas-clinicas-de-la-criptococosis\"><\/span>What are the clinical features of cryptococcosis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The signs and symptoms of the disease are <span class=\"term\" data-term-id=\"1179\">dependent<\/span> at the site of infection. There are several main sites of infection.<\/p>\n<table class=\"borders\">\n<tbody>\n<tr>\n<th>Site of infection<\/th>\n<th>Characteristics<\/th>\n<\/tr>\n<tr>\n<td>Lung<\/td>\n<td>\n<ul>\n<li>In immunocompetent patients there can be no signs or symptoms. Often these patients will recover spontaneously without any medication.<\/li>\n<li>Immunosuppressed patients may present with mild to moderate symptoms, including <span class=\"term\" data-term-id=\"1176\">fever<\/span>, <span class=\"term\" data-term-id=\"1211\">discomfort<\/span>, dry cough, chest pain.<\/li>\n<li>Severe infection can lead to pneumonia or respiratory distress in adults <span class=\"term\" data-term-id=\"350\">syndrome<\/span>.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td>Central Nervous System (<span class=\"term\" data-term-id=\"1115\">CNS<\/span>)<\/td>\n<td>\n<ul>\n<li>\n<span class=\"term\" data-term-id=\"1053\">Meningitis<\/span> It is the most common presentation.<\/li>\n<li>Signs and symptoms include headache, altered mental status, confusion, lethargy, nausea and vomiting, blurred or double vision, seizures, and coma.<\/li>\n<li>This form of infection is fatal without proper therapy. Death can occur from 2 weeks to several years after the onset of symptoms.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<span class=\"term\" data-term-id=\"67\">Disseminated<\/span> (<span class=\"term\" data-term-id=\"309\">extended<\/span>, involving other organs)<\/td>\n<td>\n<ul>\n<li>In severe infections, <span class=\"term\" data-term-id=\"1009\">pulmonary<\/span> and CNS disease is often associated with disseminated disease.<\/li>\n<li>The most commonly affected organs include the skin, the prostate, and the medullary cavity of the bones.<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3><span class=\"ez-toc-section\" id=\"Infeccion-criptococica-de-la-piel\"><\/span>Cryptococcal infection of the skin<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>Skin infection occurs in 10 to 15% of patients infected with <em>C. neoformans<\/em>.<\/li>\n<li>In immunocompetent patients, the skin may be the only site of infection.<\/li>\n<li>In immunosuppressed patients, especially those with HIV infection or AIDS, skin infection is usually a <span class=\"term\" data-term-id=\"899\">sign<\/span> of disseminated disease.<\/li>\n<li>Skin infection presents as:\n<ul>\n<li>\n<span class=\"term\" data-term-id=\"366\">Papules<\/span>, <span class=\"term\" data-term-id=\"1016\">pustules<\/span>, <span class=\"term\" data-term-id=\"367\">nodules<\/span> and <span class=\"term\" data-term-id=\"1279\">ulcers<\/span>\n<\/li>\n<li>Bleeding into the skin, presenting as <span class=\"term\" data-term-id=\"229\">petechiae<\/span> or <span class=\"term\" data-term-id=\"76\">ecchymosis<\/span>.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-diagnostica-la-criptococosis\"><\/span>How is cryptococcosis diagnosed?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The following laboratory and radiology tests are performed to aid in the diagnosis of cryptococcal disease.<\/p>\n<ul>\n<li>\n<span class=\"term\" data-term-id=\"1874\">Sputum<\/span> <span class=\"term\" data-term-id=\"837\">culture<\/span> and stain<\/li>\n<li>Lung <span class=\"term\" data-term-id=\"24\">biopsy<\/span>\n<\/li>\n<li>Bronchoscopy<\/li>\n<li>CSF culture and staining<\/li>\n<li>Chest x-ray<\/li>\n<\/ul>\n<p>The skin biopsy shows characteristics <span class=\"term\" data-term-id=\"129\">histopathology<\/span>.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCual-es-el-tratamiento-para-la-criptococosis\"><\/span>What is the treatment for cryptococcosis?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treatment of cryptococcal disease depends on the patient. <span class=\"term\" data-term-id=\"464\">immune <\/span>status and site of infection. It is based on the following categories of infection.<\/p>\n<ol>\n<li>Pulmonary cryptococcosis in an immunocompetent patient<\/li>\n<li>Pulmonary cryptococcosis in an immunosuppressed patient<\/li>\n<li>CNS cryptococcosis<\/li>\n<li>Non-pulmonary disseminated cryptococcosis, non-CNS<\/li>\n<\/ol>\n<p>Immunocompetent patients with <span class=\"term\" data-term-id=\"731\">asymptomatic<\/span> Lung disease usually does not require any treatment. If the disease does not resolve spontaneously, the antifungal fluconazole can be given for 3 to 6 months.<\/p>\n<p>Treatment goals for categories 2, 3, and 4 differ depending on whether the patient also has HIV \/ AIDS. The goal in HIV \/ AIDS infected patients is first <span class=\"term\" data-term-id=\"1854\">control<\/span> infection, followed by lifelong treatment to suppress <em>C. neoformans<\/em>. For patients with cryptococcal disease uncomplicated by HIV \/ AIDS, the goal of treatment is to eradicate the fungi and achieve a permanent cure.<\/p>\n<p>Various antifungal medications are used.<\/p>\n<ul>\n<li>Intravenous amphotericin B is the drug of choice for the initial therapy of disseminated, pulmonary, and CNS cryptococcosis.<\/li>\n<li>Flucytosine should be used in conjunction with amphotericin B.<\/li>\n<li>Oral fluconazole can be used for less serious infections and is used for lifelong treatment to prevent <span class=\"term\" data-term-id=\"1501\">relapses<\/span>.<\/li>\n<\/ul>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>\u00bfQu\u00e9 es la criptococosis? La criptococosis es un hongo infecci\u00f3n causado por inhalar el hongo Cryptococcus neoformans, que se encuentra principalmente en suelos enriquecidos con excrementos de paloma. En la&#8230;<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-6610","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/6610","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=6610"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/6610\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=6610"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=6610"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=6610"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}