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Criptococose : caracterização clínica e epidemiológica de uma coorte de doentes
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Introdução: Cryptococcus spp. é um fungo que possui múltiplos fatores de virulência que lhe confere a capacidade de provocar quadros clínicos graves, geralmente de meningoencefalite, porém com uma apresentação clínica muito variada, visto que qualquer órgão pode estar afetado.
Objetivo: Este estudo debruça-se sobre uma coorte retrospetiva e tem como objetivo avaliar as características clínicas e epidemiológicas dos doentes com criptococose seguidos no Serviço de Doenças Infeciosas do Hospital Garcia de Orta durante os anos de 2017 a 2022.
Métodos: O laboratório forneceu uma lista de 17 doentes que obtiveram o diagnóstico de criptococose seja por teste de antigénio, exame direto, ou outro método diagnóstico. Os dados colhidos foram de natureza diversa: epidemiológica, laboratorial e clínica. Avaliaram-se ainda a presença de comorbilidades, bem como o prognóstico de cada doente.
Resultados: A média de idades dos doentes incluídos no estudo é 49,7 anos (34-72 anos). A distribuição por sexo é relativamente semelhante, com 58,8% de homens e 41,2% de mulheres. 52,9% dos doentes eram portugueses e 41,2% eram africanos. Verificou-se que, em média, os doentes que faleceram durante o internamento têm uma idade superior, um maior número de comorbilidades relevantes, uma contagem celular de linfócitos T CD4+ inferior, uma carga viral de VIH superior e valores laboratoriais de PCR mais elevados.
Conclusão: A doença criptocócica continua a ser uma das principais causas da mortalidade, morbilidade e perda de qualidade de vida da população infetada com VIH. A população incluída no estudo tem características clínicas e epidemiológicas semelhantes às descritas na literatura.
Introduction: Cryptococcus spp. is a fungus that has multiple virulence factors that are responsible for serious clinical conditions, usually meningoencephalitis, but with a very diverse clinical presentation, since any organ can be affected. Objective: This study is a retrospective cohort and aims to evaluate the clinical and epidemiological characteristics of patients with cryptococcosis followed up at the Infectious Diseases Department of Hospital Garcia de Orta between 2017 and 2022. Methods: The laboratory provided a list of 17 patients diagnosed with cryptococcosis either by antigen test, direct examination or other diagnostic method. The data collected was of a diverse nature: epidemiological, laboratory and clinical. The presence of comorbidities and the prognosis of each patient were also assessed. Results: The average age of the patients included in the study was 49.7 years (34-72 years). The gender distribution was relatively similar, with 58.8% men and 41.2% women. 52.9% of the patients were Portuguese and 41.2% were African. It was found that, on average, patients who died during hospitalization were older, had a greater number of relevant comorbidities, a lower CD4+ T-lymphocyte cell count, a higher HIV viral load and higher laboratory CRP values. Conclusion: Cryptococcal disease continues to be one of the main causes of mortality, morbidity and loss of quality of life in the HIV-infected population. The population included in the study has clinical and epidemiological characteristics similar to those described in the literature.
Introduction: Cryptococcus spp. is a fungus that has multiple virulence factors that are responsible for serious clinical conditions, usually meningoencephalitis, but with a very diverse clinical presentation, since any organ can be affected. Objective: This study is a retrospective cohort and aims to evaluate the clinical and epidemiological characteristics of patients with cryptococcosis followed up at the Infectious Diseases Department of Hospital Garcia de Orta between 2017 and 2022. Methods: The laboratory provided a list of 17 patients diagnosed with cryptococcosis either by antigen test, direct examination or other diagnostic method. The data collected was of a diverse nature: epidemiological, laboratory and clinical. The presence of comorbidities and the prognosis of each patient were also assessed. Results: The average age of the patients included in the study was 49.7 years (34-72 years). The gender distribution was relatively similar, with 58.8% men and 41.2% women. 52.9% of the patients were Portuguese and 41.2% were African. It was found that, on average, patients who died during hospitalization were older, had a greater number of relevant comorbidities, a lower CD4+ T-lymphocyte cell count, a higher HIV viral load and higher laboratory CRP values. Conclusion: Cryptococcal disease continues to be one of the main causes of mortality, morbidity and loss of quality of life in the HIV-infected population. The population included in the study has clinical and epidemiological characteristics similar to those described in the literature.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2024
Palavras-chave
Cryptococcus Meningite VIH Imunodepressão Epidemiologia Doenças transmissíveis