What is cryptococcosis?
Cryptococcosis is an infectious disease caused by fungi of the genus Cryptoccocus. Pathology is dangerous because microorganisms affect the central nervous system, in more rare cases - skin, lungs,intestinesand mucous membranes. This disease is often manifested in people with low immunity. In the high-risk group are patients with immunodeficiency syndrome.
- Causes of the disease
- Forms of the disease
- Clinical picture
Causes of the disease
Pathogens are present almost everywhere, they are resistant to changes in the environment. But they prefer to settle in a humid climate. People who are prone to the disease, can get it anywhere.
Scientifically proven that the main carrier of fungi is pigeons, although the birds themselves do not get an infection. The microorganisms are contained in the litter of pigeons, separated from their nests.
The main groups of risk include the following categories of people:
- patients with leukemia;
- patients who underwent surgery;
- people weakened by a long course of a chronic illness;
- as a result of disruption of the endocrine system;
- people who take long-term cytotoxic drugs or glucocorticoids;
- patients with viral infections;
- people after transplantation of some internal organ.
According to statistics, men are more vulnerable to cryptococcosis, 75% of all cases are from the strongest part. The disease occurs in all countries, regardless of the standard of living. They can get sick and immunocompetent people, but this is rare. Symptomatics in this case is erased, they often recover without even knowing about their pathology.
Forms of the disease
Cryptococci can settle on different organs. The forms of its development depend on this. In medicine, the following types of disease are distinguished:
- cryptococcosis of the skin;
- pathology of the lungs;
- disseminated form;
- pathology of the central nervous system;
- systemic candidiasis;
- mixed form of the disease.
A person becomes infected by airborne pathology. Cryptococcus spores enter the lungs during respiration, then spread throughout the body. In rare cases, you can get infected through the skin, mucous membranes of the digestive tract (candidiasis of the esophagus).
If cryptococcosis affects a person with healthy immunity, then fungi usually settle on the lungs, in rare caseson the glands. The disease can be detected by accident. Pathology is not specific: a headache that is regular or systematic, dizziness, dyspeptic and cognitive impairment. The temperature rises in rare cases, but patients may be disturbed by a dry cough.
Fungi rarely affect the skin, it happens only when the person has a lot of damage to the skin, and the pathogen is present in large quantities. Possible manifestations of meningeal signs (impaired vision, paralysis of the facial nerve), because patients have long been increased intracranial pressure.
The second variant of the development of the disease is much more common. When a person with immunodeficiency falls ill with cryptococcosis, the symptoms are completely different, they are clearly pronounced. Doctors ascertain the severe course of the pathology. The signs are as follows:
- increase in temperature to 40 degrees;
- severe headache, which is characterized by seizures;
- a disturbance of consciousness, sometimes delirium is possible.
- the patient becomes apathetic.
Fungi first affect the nervous system, after which they are localized to other organs, causing other signs.
When settling on the lungs, bilateral pneumonia develops in the patients. Patients are worried about fever, aching chest pain, wet cough (sometimes sputum goes away with blood). The patient quickly develops respiratory failure.
If cryptococci are localized on the skin, then the patient is usually affected by the upper half of the trunk. On the skin, papules, furuncles, acne-like rashes progress. They can affect not only the skin, but also the mucous membranes of the mouth. But this form of cryptococcosis is quite rare, only in 10% of all cases.
In the case of disseminated form, patients suffer from bones, lymph nodes, kidneys, heart, and organs of vision.
Initially, the doctor examines the patient, listens to his complaints. Then, analyzes are given. Clinical diagnosis can be made only on the basis of laboratory and instrumental studies.
Laboratory methods include:
- cultural diagnostics;
- nucleic acid hybridization;
The research is based on the fact that in biological material (blood, urine, scrapes with ulcers on the skin)looking for fungi. If they are present, the patient is diagnosed with cryptococcosis.
Diagnosis is supplemented by instrumental methods. They help determine where the fungus is located and what the current state of the body is. These include: lung fluorography, bronchoscopy, spinal puncture, lung biopsy.
Therapy is handled by an infectious disease doctor. With timely access to the hospital, the outlook is favorable. If the treatment is delayed, the patient will fall into a coma and it will be fatal. In patients with immunonecompetence, relapses are observed. So, in case of HIV infection, cryptococcosis repeats within one year in half of all recorded cases.
Therapy is aimed at preventing the fungus from penetrating into the brain, and does not damage its membranes. The tactics of treatment completely depends on the location of the fungus. The dosage of medications is determined by the attending physician, based on the patient's condition. At too high doses of drugs can cause significant harm to the body, up to renal failure.
Since 1958, antifungal drugs have been used in the treatment of cryptococcosis. After this introduction, the patients began to recover, before 99% of all diseases ended in the death of patients. As antimycotic drugs use "Lamisil creamFluconazoleItraconazole". In case of increased intracranial pressure, patients are prescribed "Diacarb "Mannitol" or drugs from the category of glucocorticoids. For the prevention of fever, "Dimedrol" or "Paracetamol" is taken.
General preventive measures are aimed at strengthening the protective properties of the body. This works when it comes to immunocompetent people. They will help maintain a healthy lifestyle: normalizing nutrition, alternating rest and work, regular exercise, taking vitamins.
But the disease is more common in people with immunodeficiency. Here these events are powerless. Prevention is that people at risk should regularly take antifungal drugs (for example: "Fluconazole"). Dosage prescribed by a doctor. But if the risk of getting sick is not high, then taking antimycotic drugs will only harm the human condition.
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Cryptococcosis is a pathology caused by fungi of the genus Cryptococcus. Most often the disease affects the central nervous system. Less common is the disseminated form, the pathology of the lungs and skin. The action of fungi is susceptible to patients with immunodeficiency. Sometimes immunocompetent people fall ill. With timely access to a doctor, the prognosis of treatment is favorable.