Estudio de las principales manifestaciones neurologicas en pacientes vih positivos, asociados a criptocococis cerebral a realizar en el Hospital de Infectología Dr. José Rodríguez Maridueña en el 2014-2015
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2017
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
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La Criptococosis es una micosis sistémica de distribución mundial causada por criptococcus neoformans patógeno oportunista que produce enfermedad en pacientes con compromiso marcado de la inmunidad celular, como en pacientes con infección por el virus de la inmunodeficiencia humana. Constituye una de las tres micosis prevalentes en pacientes VIH (+) siendo la que presenta en mayor proporción un cuadro diseminado. La incidencia de criptococosis, en los pacientes con SIDA es del 3 al 6% en EE.UU. y en Europa occidental, del 15 al 30% en África y En Ecuador podría ser la primera manifestación de la infección por VIH.
El propósito de este trabajo es identificar las principales manifestaciones neurológicas en pacientes VIH positivos, asociados a criptocococis cerebral; para poder dar un tratamiento efectivo y evitar las complicaciones neurológicas estudio a que se realizó en el hospital DR. JOSE RODRIGUEZ MARIDUEÑA en el 2014-2015.
La presente investigación es de enfoque cuantitativo, retrospectivo, descriptivo, de diseño no experimental, de corte transversal, siguiendo un método de observación indirecta y análisis correlacional.
El sexo más afectado por criptococosis cerebral con VIH positivo es el masculino, 81% Las formas clínicas más frecuentes en las que se presenta la criptococosis en los pacientes VIH positivos son: criptococosis meníngea 33%, diseminada 31%, cerebral 29%, meningo-encefalitis 7%. La población joven es la que está más afectada; 31% tenían edades de 36 a 50 años y 16% más de 50 años.
Los pacientes que no reciben tratamiento antirretroviral (TARV) o abandonan el tratamiento aumenta la morbimortalidad por criptococosis en 70%.Se debe conocer a cabalidad las manifestaciones neurológicas, ya que, permite pensar en criptococosis desde el primer momento que se recibe al paciente en emergencia y de esta manera no retardar el diagnostico. El 59% presentó cefalea como motivo de consulta, el 31% fiebre, confusión y rigidez de nuca 4%, y papiledema 2%.
Cryptococcosis is a systemic mycosis of global distribution caused by opportunistic pathogen cryptococcus neoformans that causes disease in patients with marked compromise of cellular immunity, as in patients with infection by the human immunodeficiency virus. It is one of the three mycoses prevalent in HIV (+) patients, being the one with the highest proportion of disseminated disease. The incidence of cryptococcosis in patients with AIDS is 3 to 6% in the USA. And in Western Europe, 15-30% in Africa and in Ecuador could be the first manifestation of HIV infection. The purpose of this paper is to identify the main neurological manifestations in hiv positive patients, associated with cerebral cryptocococci; To be able to give an effective treatment and to avoid the neurological complications study that was realized in the DR hospital. JOSE RODRIGUEZ MARIDUEÑA in 2014-2015. The present research is a quantitative, retrospective, descriptive, non - experimental, cross - sectional approach, following a method of indirect observation and correlational analysis. The most common clinical forms of cryptococcosis in HIV-positive patients are: meningeal cryptococcosis 33%, disseminated 31%, cerebral 29%, meningo- Encephalitis 7%. The young population is the most affected; 31% were 36 to 50 years old and 16% older than 50 years. Patients who do not receive antiretroviral treatment (ART) or abandon treatment increase cryptorectomy morbidity and mortality by 70%. Neurological manifestations must be fully known, since it allows thinking of cryptococcosis from the first moment the patient is received in an emergency And in this way do not delay the diagnosis. 59% presented headache as a reason for consultation, 31% fever, confusion and stiff neck 4%, and papilledema 2%
Cryptococcosis is a systemic mycosis of global distribution caused by opportunistic pathogen cryptococcus neoformans that causes disease in patients with marked compromise of cellular immunity, as in patients with infection by the human immunodeficiency virus. It is one of the three mycoses prevalent in HIV (+) patients, being the one with the highest proportion of disseminated disease. The incidence of cryptococcosis in patients with AIDS is 3 to 6% in the USA. And in Western Europe, 15-30% in Africa and in Ecuador could be the first manifestation of HIV infection. The purpose of this paper is to identify the main neurological manifestations in hiv positive patients, associated with cerebral cryptocococci; To be able to give an effective treatment and to avoid the neurological complications study that was realized in the DR hospital. JOSE RODRIGUEZ MARIDUEÑA in 2014-2015. The present research is a quantitative, retrospective, descriptive, non - experimental, cross - sectional approach, following a method of indirect observation and correlational analysis. The most common clinical forms of cryptococcosis in HIV-positive patients are: meningeal cryptococcosis 33%, disseminated 31%, cerebral 29%, meningo- Encephalitis 7%. The young population is the most affected; 31% were 36 to 50 years old and 16% older than 50 years. Patients who do not receive antiretroviral treatment (ART) or abandon treatment increase cryptorectomy morbidity and mortality by 70%. Neurological manifestations must be fully known, since it allows thinking of cryptococcosis from the first moment the patient is received in an emergency And in this way do not delay the diagnosis. 59% presented headache as a reason for consultation, 31% fever, confusion and stiff neck 4%, and papilledema 2%
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Criptococosis, Manifestaciones neurológicas, Virus de inmunodeficiencia humana, Hospital de Infectología Dr. José Daniel Rodríguez Maridueña, Cantón Guayaquil, Ecuador