| Autor: |
Laurenson, I.F., Trevett, A.J., Lalloo, D.G., Nwokolo, N., Naraqi, S., Black, J., Tefurani, N., Saweri, A., Mavo, B., Igo, J., Warrell, D.A. |
| Zdroj: |
Transactions of the Royal Society of Tropical Medicine & Hygiene; January 1996, Vol. 90 Issue: 1 p57-60, 4p |
| Abstrakt: |
Eleven cases of cryptococcal meningitis were diagnosed and biotyped from September 1991 to August 1992 in Papua New Guinea (PNG). Seven isolates were Cryptococcus neoformansvar. gattiifrom paediatric and adult patients, one with diabetes mellitus and 4 were C. neoformansvar. neoformansfrom adults, of whom 2 had human immunodeficiency virus type 1 (HIV-1) infection, and one each had tuberculosis and Plasmodium vivaxmalaria. Significant clinical findings were headache, fever, meningism, vomiting, photophobia, papilloedema and cranial nerve lesions. Five patients (45.5%) died; 3 of these were adults with var. gattiiand 2 were men with both var.neoformansand HIV-1 infections. This prospective tropical study documents the emergence of C. neoformansvar. neoformansin patients with HIV-1 infection in a country where previously var. gattiihad predominated in the immunocompetent. There has been no earlier report of cryptococcosis in an HIV-1 seropositive patient in PNG. Despite presumed exposure to both varieties of C. neoformans, var. gattiiinfections had been most frequent. As HIV-1 spreads, the proportion of hosts infected with var. neoformansmay rise. The course of meningitis caused by the 2 varieties of C. neoformansmay differ, with mortality in the tropics remaining particularly high. In PNG the environmental source of C. neoformansremains elusive. |
| Databáze: |
Supplemental Index |
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