Factores de riesgos en pacientes vih con criptococosis meníngea y su tendencia en pacientes del Hospital de Infectología Dr. José Daniel Maridueña, período enero a diciembre 2014
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2015
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
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Desde el inicio de la pandemia de la infección por el virus de la inmunodeficiencia humana (VIH) en 1981, las infecciones micóticas constituyen una parte importante de las infecciones oportunistas. A pesar del gran avance que ha supuesto el tratamiento antirretroviral (TAR) para el pronostico de la infeccion por el VIH, las infecciones oportunistas (IO) continuan siendo causa de morbilidad y mortalidad en estos pacientes. Esto suele ocurrir en muchos casos debido a la inmunodepresion grave, bien ante la falta de adherencia al tratamiento antirretroviral, el fracaso del mismo o el desconocimiento de la existencia de la infección por el VIH en pacientes que debutan con una Infeccion oportunista . Entre una de las principales causas de muerte en pacientes con síndrome de inmunodeficiencia adquirida ( sida) tenemos a la criptococosis meníngea , esta infección oportunista cuyo agente principal es criptococus neoformans . El C. neoformans posee una distribucion universal, desarrollandose preferentemente en ambientes enriquecidos con componentes nitrogenados, principalmente a partir de las excretas desecadas de las palomas que son ricas en nitrogeno y creatinina, con alto contenido en sales y pH alcalino, cualidades que facilitan la supervivencia del hongo. Las levaduras pueden mantenerse viables en los excrementos de las palomas durante dos o mas anos, siempre que se encuentren a resguardo de los rayos solares, ya que estos son esterilizantes.
En la naturaleza las levaduras poseen capsulas de tamaño reducido, lo cual favorece su inhalación. provocando en huéspedes inmunocopetentes una primoinfeccion asintomática constituyendo en pacientes inmunodeprimidos su principal factor de riesgo para contraer dicha infeccion .
Palabras clave: VIH SIDA /FACTORES DE RIESGO/ CRIPTOCOCOSIS MENINGEA
Since the beginning of the pandemic of infection with human immunodeficiency virus (HIV) in 1981, fungal infections are an important part of opportunistic infections. Despite the great progress that has led to the antiretroviral therapy (ART) for the prognosis of HIV infection, opportunistic infections (OIs) continue to cause morbidity and mortality in these patients. This usually happens in many cases because of severe immunosuppression, either due to the lack of adherence to antiretroviral therapy, failure thereof or the ignorance of the existence of HIV infection in patients presenting with an opportunistic infection. Among one of the leading causes of death in patients with acquired immunodeficiency syndrome (AIDS) we have a meningeal cryptococcosis, this opportunistic infection whose main agent is cryptococcal neoformans. C. neoformans has a universal distribution, preferably being developed in environments enriched with nitrogenous compounds, mainly from the dried excreta of pigeons that are rich in nitrogen and creatinine, with high salt and alkaline pH, qualities that facilitate survival the fungus. Yeasts can remain viable in pigeon droppings for two or more years, provided they are protected from sunlight, since these are sterilizing. In nature yeast capsules have reduced size,which favors inhalation. resulting in inmunocopetentes guests asymptomatic primary infection in immunocompromised patients constitute the main risk factor for contracting the infection
Since the beginning of the pandemic of infection with human immunodeficiency virus (HIV) in 1981, fungal infections are an important part of opportunistic infections. Despite the great progress that has led to the antiretroviral therapy (ART) for the prognosis of HIV infection, opportunistic infections (OIs) continue to cause morbidity and mortality in these patients. This usually happens in many cases because of severe immunosuppression, either due to the lack of adherence to antiretroviral therapy, failure thereof or the ignorance of the existence of HIV infection in patients presenting with an opportunistic infection. Among one of the leading causes of death in patients with acquired immunodeficiency syndrome (AIDS) we have a meningeal cryptococcosis, this opportunistic infection whose main agent is cryptococcal neoformans. C. neoformans has a universal distribution, preferably being developed in environments enriched with nitrogenous compounds, mainly from the dried excreta of pigeons that are rich in nitrogen and creatinine, with high salt and alkaline pH, qualities that facilitate survival the fungus. Yeasts can remain viable in pigeon droppings for two or more years, provided they are protected from sunlight, since these are sterilizing. In nature yeast capsules have reduced size,which favors inhalation. resulting in inmunocopetentes guests asymptomatic primary infection in immunocompromised patients constitute the main risk factor for contracting the infection
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Factores de riesgo, Virus de inmunodeficiencia humana, Meningitis, Criptococosis, Hospital de Infectología Dr. José Daniel Rodríguez Maridueña, Cantón Guayaquil, Ecuador, Síndrome de inmunodeficiencia adquirida, Epidemiología descriptiva