免疫功能正常患者由新生隐球菌VNI引起的播散性和皮肤隐球菌病

Q4 Medicine

Jornal Brasileiro de Patologia e Medicina Laboratorial Pub Date : 2020-01-01 DOI:10.5935/1676-2444.20200017

F. C. A. Maranhão, Douglas L. H. Fonseca, Graciella S. A. Santos, L. A. Fonseca, E. J. Santos, D. W. Silva

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引用次数: 2

摘要

隐球菌病是由新型隐球菌/C的酵母菌引起的。加蒂复合体，表现为皮肤、呼吸和播散形式。44岁男性，面部病变伴潜伏性肺炎住院，误诊为副球孢子菌病。计算机断层扫描显示肺部和神经系统受累，培养/墨迹、隐球菌抗原检测和脲酶基因限制性片段长度多态性(URA5 -RFLP)证实新生C. VNI基因型。血液培养显示为耐氨苄西林肺炎克雷伯菌(卫生保健相关感染)。给予氟康唑，经耐药检测后选择两性霉素B(累积剂量/1500 mg)。患者出院时临床缓解(75天)，两性霉素治疗1年(维持期)。

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Disseminated and cutaneous cryptococcosis by C. neoformans VNI in an immunocompetent patient

Cryptococcosis is caused by yeasts of the Cryptococcus neoformans/C. gattii complex, presenting cutaneous, respiratory and disseminated forms. A 44-year-old immunocompetent male with facial lesion and latent pneumonia was hospitalized and misdiagnosed with paracoccidioidomycosis. Computerized tomography scans showed pulmonary and neurological involvement, and cultures/China ink, cryptococcal antigen test and restriction fragment length polymorphism of urease gene ( URA5 -RFLP) confirmed C. neoformans genotype VNI. Hemoculture indicated ampicillin-resistant Klebsiella pneumoniae (healthcare-associated infection). Fluconazole was administered, but after resistance detection, amphotericin B was chosen (cumulative dose/1500 mg). The patient was discharged with clinical remission (75 days) and amphotericin for one year (maintenance phase).

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来源期刊

Jornal Brasileiro de Patologia e Medicina Laboratorial Health Professions-Medical Laboratory Technology

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

20 weeks

期刊介绍： The Jornal Brasileiro de Patologia e Medicina Laboratorial (Brazilian Journal of Pathology and Laboratory Medicine), a continuation of Jornal Brasileiro de Patologia (Brazilian Journal of Pathology), and published quarterly (March, June, September and December) is directed towards the publication of scientific articles that contribute to the development of the area of Laboratory Medicine (Clinical Pathology, Pathology, Cytopathology). It accepts the following categories of articles: original articles, review articles, case reports, short communications, updating articles, letters to editors and reviews.