Contribution to the study of infant cryptococosis in Cuba

[摘要] Introduction: since 1998, an increasing number of Cryptococcus isolates obtained from HIV-negative children with meningoencephalitis was observed in the mycology laboratory at "Pedro Kourí" Institute. The global reports of child cryptococcosis are rare and usually associated with AIDS. Objectives: to study child cryptococosis in Cuba through the comprehensive evaluation of 7 cases. Methods: the clinical histories of seven pediatric patients with cryptococcal meningoencephalitis were examined and the obtained isolates (one per patient) were characterized. The species, variety, serotype, pathogenicity in a mouse model and amphotericin B susceptibility of the isolates were determined. Results: average age of the children was 5.8 years, with a slight female predominance (4:3). The most common symptoms were headache, photophobia, fever and vomiting. The cytochemical study of cerebral spinal fluid and skull imaging test showed abnormalities in 6 patients. The microbiological diagnosis was made through direct examination and culture. All the isolates were from Cryptococcus neoformans serotype A and amphotericin B showed a minimum inhibitory concentration £ 0.125 mg/mL. In the group, 85.7 % showed phenoloxidase activity and high lethality rate in infected animals (71.4 to 100 %). Conclusions: the prognosis of cryptococcal meningoencephalitis is closely linked to early diagnosis, therefore, this should be always kept in mind and the provided data from this study may serve as warning to attending physicians.

[学科分类] 传染病学

[关键词] Cryptococcus neoformans;meningoencephalitis;children;susceptibility;pathogenicity