RESUMEN
We analysed 15,101 biological samples from patients presenting with superficial mycoses who attended outpatient services over a 10-year period. Scale samples were processed for direct microscopic examination with 15% KOH and cultured on Sabouraud glucose agar plus chloramphenicol and cycloheximide. Laboratory examination confirmed 4,709 cases of superficial mycosis (31.18%), of which 2,084 (44.26%) were dermatophytoses. The species most frequently encountered was Trichophyton rubrum (71.2%), followed by T. tonsurans (6.9%), T. mentagrophytes (5.5%), Microsporum canis (4.5%) and Epidermophyton floccosum (1.3%). The most frequent clinical form of dermatophytosis was tinea unguium (59.9%), followed by tinea pedis (24.5%). We demonstrate that the number of cases of T. rubrum is increasing in Mexico.
Asunto(s)
Arthrodermataceae/clasificación , Arthrodermataceae/aislamiento & purificación , Dermatomicosis/epidemiología , Dermatomicosis/microbiología , Animales , Arthrodermataceae/citología , Arthrodermataceae/crecimiento & desarrollo , Medios de Cultivo/química , Femenino , Humanos , Masculino , México/epidemiología , Microscopía , Micología/métodosRESUMEN
Coccidioidomycosis is a mycosis firstly pulmonar caused by Coccidioides immitis; it can be disseminated to central nervous system, bones and skin, principaly. In Mexico, the real frequency of the disease is unknown. The aim of this work was to determine, by skin test and by serology, the infection cases by C. immitis in twelve communities (10 rural and two urban), attended in the Hospital Rural No 79 at the Instituto Mexicano del Seguro Social (IMSS) from the Coahuila State, Mexico. Six hundred and sixty eight adult individuals of both sexes were studied, to whom 0.1 ml of coccidioidin by intradermal route was applied; 72 h after, the induration diameter was measured. One hundred eighty individuals were selected and seric anti-C. immitis immunoglobulins levels were determined by ELISA. Six hundred twenty one individuals (93%) were positive to coccidioidin, the frequency was much higher than that previously reported in Coahuila. From 180 sera studied, the means of optical density (OD) were: IgG1, 1.55; IgG2, 0.94; total IgG, 0.33; IgG3, 0.29; IgG4, 0.27; IgM, 0.08. The values of IgG1, IgG2 and IgM compared with the other immunoglobulins were statistically significant. The high values of IgG1 and IgG2 suggest frequent contact with the antigen, and probable cases of undiagnosed disease.
Asunto(s)
Coccidioides/aislamiento & purificación , Coccidioidomicosis/epidemiología , Adulto , Anciano , Anticuerpos Antifúngicos/sangre , Coccidioides/inmunología , Coccidioidina , Coccidioidomicosis/diagnóstico , Coccidioidomicosis/microbiología , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Pruebas Intradérmicas , Masculino , México/epidemiología , Persona de Mediana Edad , Población Rural , Población UrbanaRESUMEN
La coccidioidomicosis es una micosis inicialmente pulmonar causada por Coccidioides immitis; puede diseminarse principalmente a sistema nervioso central, huesos y piel. En México se desconoce la frecuencia exacta de esta enfermedad. Nuestro objetivo fue determinar, por intradermorreacción y por serología, los casos de infección por C. immitis en 12 comunidades (10 rurales y dos urbanas) atendidas en el Hospital Rural Nº 79 del Instituto Mexicano del Seguro Social (IMSS) del estado de Coahuila, México. Se estudiaron 668 individuos adultos de ambos sexos; se les aplicó 0,1 ml de coccidioidina por vía intradérmica; después de 72 hs. se midió el diámetro de induración. Fueron seleccionados 180 individuos y a partir del suero se determinaron los niveles de inmunoglobulinas anti-C. immitis por ELISA. Fueron positivos a la coccidioidina 621 sujetos (93%), frecuencia mucho mayor a la reportada previamente en Coahuila. De los 180 sueros estudiados los promedios de densidad óptica (DO) fueron: IgG1, 1,55; IgG2, 0,94; IgG total, 0,33; IgG3, 0,29; IgG4, 0,27; IgM, 0,08. Los valores de IgG1, IgG2 e IgM comparados con las otras inmunoglobulinas fueron estadísticamente significativos. Los valores de IgG1 e IgG2 sugieren contacto frecuente con los antígenos e incluso probables casos de enfermedad no diagnosticada.
Coccidioidomycosis is a mycosis firstly pulmonar caused by Coccidioides immitis; it can be disseminated to central nervous system, bones and skin, principaly. In Mexico, the real frequency of the disease is unknown. The aim of this work was to determine, by skin test and by serology, the infection cases by C. immitis in twelve communities (10 rural and two urban), attended in the Hospital Rural Nº 79 at the Instituto Mexicano del Seguro Social (IMSS) from the Coahuila State, Mexico. Six hundred and sixty eight adult individuals of both sexes were studied, to whom 0.1 ml of coccidioidin by intradermal route was applied; 72 h after, the induration diameter was measured. One hundred eighty individuals were selected and seric anti-C. immitis immunoglobulins levels were determined by ELISA. Six hundred twenty one individuals (93%) were positive to coccidioidin, the frequency was much higher than that previously reported in Coahuila. From 180 sera studied, the means of optical density (OD) were: IgG1, 1.55; IgG2, 0.94; total IgG, 0.33; IgG3, 0.29; IgG4, 0.27; IgM, 0.08. The values of IgG1, IgG2 and IgM compared with the other immunoglobulins were statistically significant. The high values of IgG1 and IgG2 suggest frequent contact with the antigen, and probable cases of undiagnosed disease.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Coccidioides/aislamiento & purificación , Coccidioidomicosis/epidemiología , Anticuerpos Antifúngicos/sangre , Coccidioides/inmunología , Coccidioidina , Coccidioidomicosis/diagnóstico , Coccidioidomicosis/microbiología , Pruebas Intradérmicas , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , México/epidemiología , Población Rural , Población UrbanaRESUMEN
Coccidioidomycosis is a mycosis firstly pulmonar caused by Coccidioides immitis; it can be disseminated to central nervous system, bones and skin, principaly. In Mexico, the real frequency of the disease is unknown. The aim of this work was to determine, by skin test and by serology, the infection cases by C. immitis in twelve communities (10 rural and two urban), attended in the Hospital Rural No 79 at the Instituto Mexicano del Seguro Social (IMSS) from the Coahuila State, Mexico. Six hundred and sixty eight adult individuals of both sexes were studied, to whom 0.1 ml of coccidioidin by intradermal route was applied; 72 h after, the induration diameter was measured. One hundred eighty individuals were selected and seric anti-C. immitis immunoglobulins levels were determined by ELISA. Six hundred twenty one individuals (93
) were positive to coccidioidin, the frequency was much higher than that previously reported in Coahuila. From 180 sera studied, the means of optical density (OD) were: IgG1, 1.55; IgG2, 0.94; total IgG, 0.33; IgG3, 0.29; IgG4, 0.27; IgM, 0.08. The values of IgG1, IgG2 and IgM compared with the other immunoglobulins were statistically significant. The high values of IgG1 and IgG2 suggest frequent contact with the antigen, and probable cases of undiagnosed disease.
RESUMEN
Considerando que algunos autores han reportado un aumento en la cantidad de algunas inmunoglobulinas en los pacientes con actinomicetoma, en este trabajo nos propusimos determinar diferencias en la producción de IgG1, IgG2, IgG3, IgG4 e IgM en 25 pacientes con actinomicetoma por Nocardia brasiliensis y 25 personas sanas provenientes de una zona endémica de micetoma. La determinación de inmunoglobulinas se realizó por medio de la técnica de ELISA. Para sensibilizar las placas se emplearon 6 antígenos de N. brasiliensis: un antígeno crudo denominado NB y cinco derivados del mismo (NB2, NB4, NB6, NB8 y NB10) separados por punto isoeléctrico. Los niveles de las cuatro subclases de IgG fueron mayores en los sueros de los pacientes que en el suero de los controles, con una diferencia máxima en IgG3 e IgG4; para esta última subclase, los seis antígenos fueron altamente reactivos. La concentración de IgM fue igual en ambos grupos. Es probable que como ocurre en otras infecciones, en la fisiopatogenia del actinomicetoma influya no sólo el aumento o deficiencia de una clase de inmunoglobulina, sino la relación que existe entre las diferentes subclases.
Considering that some authors have reported an increasing of some immunoglobulins in actinomycetoma patients, in this study we propose to determine differential production of IgG1, IgG2, IgG3, IgG4 and IgGM in 25 patients with actinomycetoma and 25 healthy individuals from a mycetoma endemic area. Immunoglobulins were determined by ELISA technique. To sensibilize the plates, six Nocardia brasiliensis antigens were used: a crude antigen denominated NB and five derivatives (NB2, NB4, NB6, NB8 and NB10) obtained by their isoelectric point. Results showed that all IgG subclasses were higher in the patients’ sera than in control sera, with a maximal difference to IgG3 and IgG4. To the latter subclass, six antigens were highly reactives. IgM levels were similar in both groups. As it occurs in other infections, in the actinomycetoma pathogenesis probably participate the increase or deficiency of a determined immunoglobulin class, as well as the relationship between different subclasses.
Asunto(s)
Adulto , Femenino , Humanos , Masculino , Anticuerpos Antibacterianos/inmunología , Micetoma/inmunología , Nocardiosis/inmunología , Especificidad de Anticuerpos , Anticuerpos Antibacterianos/sangre , Anticuerpos Antibacterianos/aislamiento & purificación , Antígenos Bacterianos/inmunología , Ensayo de Inmunoadsorción Enzimática , Punto Isoeléctrico , Inmunoglobulina G/sangre , Inmunoglobulina G/clasificación , Inmunoglobulina G/inmunología , Inmunoglobulina G/aislamiento & purificación , Inmunoglobulina M/sangre , Inmunoglobulina M/inmunología , Inmunoglobulina M/aislamiento & purificación , Micetoma/microbiología , Nocardiosis/sangreRESUMEN
Considering that some authors have reported an increasing of some immunoglobulins in actinomycetoma patients, in this study we propose to determine differential production of IgG1, IgG2, IgG3, IgG4 and IgGM in 25 patients with actinomycetoma and 25 healthy individuals from a mycetoma endemic area. Immunoglobulins were determined by ELISA technique. To sensibilize the plates, six Nocardia brasiliensis antigens were used: a crude antigen denominated NB and five derivatives (NB2, NB4, NB6, NB8 and NB10) obtained by their isoelectric point. Results showed that all IgG subclasses were higher in the patients' sera than in control sera, with a maximal difference to IgG3 and IgG4. To the latter subclass, six antigens were highly reactives. IgM levels were similar in both groups. As it occurs in other infections, in the actinomycetoma pathogenesis probably participate the increase or deficiency of a determined immunoglobulin class, as well as the relationship between different subclasses.
Asunto(s)
Anticuerpos Antibacterianos/inmunología , Micetoma/inmunología , Nocardiosis/inmunología , Adulto , Anticuerpos Antibacterianos/sangre , Anticuerpos Antibacterianos/aislamiento & purificación , Especificidad de Anticuerpos , Antígenos Bacterianos/inmunología , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina G/clasificación , Inmunoglobulina G/inmunología , Inmunoglobulina G/aislamiento & purificación , Inmunoglobulina M/sangre , Inmunoglobulina M/inmunología , Inmunoglobulina M/aislamiento & purificación , Punto Isoeléctrico , Masculino , Micetoma/microbiología , Nocardiosis/sangreRESUMEN
Considering that some authors have reported an increasing of some immunoglobulins in actinomycetoma patients, in this study we propose to determine differential production of IgG1, IgG2, IgG3, IgG4 and IgGM in 25 patients with actinomycetoma and 25 healthy individuals from a mycetoma endemic area. Immunoglobulins were determined by ELISA technique. To sensibilize the plates, six Nocardia brasiliensis antigens were used: a crude antigen denominated NB and five derivatives (NB2, NB4, NB6, NB8 and NB10) obtained by their isoelectric point. Results showed that all IgG subclasses were higher in the patients sera than in control sera, with a maximal difference to IgG3 and IgG4. To the latter subclass, six antigens were highly reactives. IgM levels were similar in both groups. As it occurs in other infections, in the actinomycetoma pathogenesis probably participate the increase or deficiency of a determined immunoglobulin class, as well as the relationship between different subclasses.
RESUMEN
Blastomycosis is an acute or chronic primary infection of the respiratory system, endemic in North America (United States of America and Canada), Africa and Asia. We report a case in Mexico, in a three years old child who had been born in California and lived in Chicago, U.S.A. The patient presented pulmonary symptoms prior to development of a skin ulcer. Blastomyces dermatitidis was identified by mycological and molecular procedures. The patient was successfully treated with amphotericin B, oral ketoconazole and itraconazole.
Asunto(s)
Blastomyces/crecimiento & desarrollo , Blastomicosis/patología , Enfermedades Pulmonares Fúngicas/patología , Úlcera Cutánea/patología , Antifúngicos/uso terapéutico , Blastomicosis/epidemiología , Blastomicosis/microbiología , Chicago/etnología , Preescolar , Humanos , Enfermedades Pulmonares Fúngicas/epidemiología , Enfermedades Pulmonares Fúngicas/microbiología , Masculino , México , Úlcera Cutánea/epidemiología , Úlcera Cutánea/microbiologíaRESUMEN
Peritonitis is a frequent complication in patients with chronic renal failure on continuous ambulatory peritoneal dialysis (CAPD) treatment. The aim of this study was to know the prevalence of fungal peritonitis on patients undergoing CAPD, and to determine the antifungal susceptibility pattern of the identified isolates. Samples of the peritoneal dialysis fluid from 165 patients on CAPD treatment with peritonitis manifestations were submitted to mycological study (direct microscopic examination, culture and antifungal susceptibility test). Ten Candida isolates were identified, being C. albicans and C. parapsilosis the most common species. From isolates obtained, three species (C. albicans, C. parapsilosis, and C. guilliermondii) presented itraconazole resistance while C. glabrata was resistant to both itraconazole and ketoconazole. Aspergillus fumigatus was associated to peritonitis in three cases and Acremonium sp. in two.
Asunto(s)
Micosis/microbiología , Diálisis Peritoneal Ambulatoria Continua/efectos adversos , Peritonitis/microbiología , Acremonium/efectos de los fármacos , Acremonium/aislamiento & purificación , Anciano , Antifúngicos/farmacología , Aspergillus/efectos de los fármacos , Aspergillus/aislamiento & purificación , Candida/efectos de los fármacos , Candida/aislamiento & purificación , Niño , Farmacorresistencia Fúngica , Femenino , Fluconazol/farmacología , Humanos , Itraconazol/farmacología , Cetoconazol/farmacología , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/terapia , Masculino , México , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Micosis/tratamiento farmacológico , Peritonitis/tratamiento farmacológicoRESUMEN
Because sporotrichosis is the most frequent subcutaneous mycosis in Mexico and the clinical aspect is not always characteristic, the aim of this study was to evaluate laboratory diagnosis techniques. Fifty patients with clinical diagnosis of subcutaneous sporotrichosis were studied including clinical and epidemiologic data. Metabolic antigen was used to elicit delayed hypersensitivity skin reaction in all patients. Exudate was plated on Sabouraud agar and biopsy material was submitted to indirect immunofluorescence and histopathology. Results showed that sporotrichosis frequency was higher in women (62%), in children and adolescents under 20 years of age (34%) and adults older than 50 years of age (28%). Disease was predominant in farmers (44%) followed by housewives (30%). Lymphangitic form accounted for 82% of cases and these were localized in upper limbs (54%). In 66% of cases, histopathology showed S. schenckii yeasts; hypersensitivity skin reaction was positive in 76% and culture in 94%. By indirect immunofluorescence, parasitic elements were demonstrated in all patients corresponding to both sensitivity and specificity 100%. In this work, indirect immunofluorescence was the most efficient sporotrichosis diagnostic method followed by culture, hypersensitivity skin reaction, and histopathologic study.
Asunto(s)
Esporotricosis/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Persona de Mediana EdadRESUMEN
Cryptococcosis frequency is increasing in Mexico. Few epidemiologic and clinical surveys exist even though 10-15% of patients with AIDS develop this mycosis. To know the situation about the prevalence and etiological agents of cryptococcosis in our country, a study including isolated Cryptococcus spp. strains took place from 1989 to August 1998. A total of 211 Cryptococcus spp. strains obtained from patients of diverse hospital centers in Mexico City were studied. This study describes cryptococcosis epidemiological data, in our country. C. neoformans was the dominant isolation (97.15%), followed by two C. albidus isolation and one C. uniguttulatus isolation. 92.5% of the strains was isolated from cerebral spinal fluid and the remaining were from bone marrow, blood, ganglion, sputum, bronchial lavage and liver biopsy. AIDS was the principal opportunistic factor (85%). Strains were found prevails in males (87.3%). It was found that the age groups where the disease appears most frequently are in the fourth (37.5%) and third (33.8%) decade of life. Finally, the isolation frequency of the C. neoformans var. neoformans (vn) and var. gattii (vg) obtained in this study (vn 86.7%) and vg 10.4%) was compared with the ones registered in Argentina (vn 97.6%, vg 2.4%); Brazil (vn 83.3%, vg 15.8%); Cuba (vn 97.6%, vg 2.4%); Paraguay (vn 0%, vg 100.0%); Puerto Rico (vn 100.0%, vg 0%) and Venezuela (vn 66.7%, vg 29.6%).
Asunto(s)
Criptococosis/microbiología , Cryptococcus/aislamiento & purificación , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Adulto , Anciano , Criptococosis/epidemiología , Cryptococcus/clasificación , Cryptococcus neoformans/aislamiento & purificación , Femenino , Hospitales , Humanos , América Latina/epidemiología , Masculino , México/epidemiología , Persona de Mediana Edad , Prevalencia , Población UrbanaRESUMEN
Nosocomial yeast infections have become a major cause of morbidity and mortality in immunocompromised patients. This study presents the frequency of yeasts isolated from different biological products from a Mexico City hospital's patients during one year. C. albicans was isolated in 72.3% of patients, followed by C. glabrata (13.4%) and C. parapsilosis (8%). Twenty different morphotypes were identified and the serotype B was the most frequent (79%).
Asunto(s)
Candidiasis/microbiología , Infección Hospitalaria/microbiología , Candida/clasificación , Femenino , Hospitalización , Humanos , Masculino , México , SerotipificaciónRESUMEN
Nosocomial yeast infections have become a major cause of morbidity and mortality in immunocompromised patients. This study presents the frequency of yeasts isolated from different biological products from a Mexico City hospitals patients during one year. C. albicans was isolated in 72.3 of patients, followed by C. glabrata (13.4) and C. parapsilosis (8). Twenty different morphotypes were identified and the serotype B was the most frequent (79).(AU)
Asunto(s)
Humanos , Masculino , Femenino , Candidiasis/microbiología , Infección Hospitalaria/microbiología , Candida/clasificación , Hospitalización , México , SerotipificaciónRESUMEN
Nosocomial yeast infections have become a major cause of morbidity and mortality in immunocompromised patients. This study presents the frequency of yeasts isolated from different biological products from a Mexico City hospital's patients during one year. C. albicans was isolated in 72.3 of patients, followed by C. glabrata (13.4) and C. parapsilosis (8). Twenty different morphotypes were identified and the serotype B was the most frequent (79).
Asunto(s)
Humanos , Masculino , Femenino , Candidiasis/microbiología , Infección Hospitalaria/microbiología , Candida , Hospitalización , México , SerotipificaciónRESUMEN
Nosocomial yeast infections have become a major cause of morbidity and mortality in immunocompromised patients. This study presents the frequency of yeasts isolated from different biological products from a Mexico City hospitals patients during one year. C. albicans was isolated in 72.3
of patients, followed by C. glabrata (13.4
) and C. parapsilosis (8
). Twenty different morphotypes were identified and the serotype B was the most frequent (79
).
RESUMEN
We show the records about diagnosed mycoses in a hospital in Mexico City in two periods of time: from 1967 to 1977 and from 1993 to 1997. In the former 15,429 patients were studied and in the latter, 5,998. Striking differences among frequency, etiological agents and clinical outcome, were observed. The most frequent infections in both lapses were the superficial ones, however the most recent scores showed a notorious increase in opportunistic infections. We diagnosed only one histoplasmosis case during the period from 1993 to 1997. Etiological agents have also changed, dermatophytes frequency like Trichophyton mentagrophytes and T. tonsurans have diminished while T. rubrum increased from 60% to 80% of the whole dermatophytoses cases. Even though Criptococcus neoformans used to be the only agent causing criptococosis, in the most recent report we found that C. laurentii, C. terreus and C. unigutulatus were also isolated. Another important difference was mortality in rhinocerebral mucormicosis: twenty years ago it was fairly 80%, nowadays it has decreased to 20%.
Asunto(s)
Micosis/epidemiología , Cryptococcus/aislamiento & purificación , Humanos , México/epidemiología , Micosis/microbiología , Estudios Retrospectivos , Trichophyton/aislamiento & purificaciónRESUMEN
The purpose of this investigation was to find out how often pathogenic dermatophytes are found in apparently normal versus scaly feet of children. In this prospective protocol, we studied 100 patients, 2 to 12 years of age, consulting for plantar and/or interdigital scaling with or without erythema, maceration, and pruritus, and 100 controls with apparently healthy feet. Direct microscopic examination (KOH) and mycologic culture (Mycosel) of skin scrapings were performed from the lesions of patients and from the soles and interdigital folds of controls. Mean age of patients and controls was 7 years 7 months (SD = 3 years 2 months). Scaling was present in 100% of patients with a mean time of evolution of 8.9 months (SD = 16.3 months). Shoes fashioned from man-made material were significantly more frequently used by patients than by controls (chi 2(df = 1) = 9.4; p = 0.002). Pathogenic dermatophytes were present in the soles and/or interdigital webs of 21 patients and 7 controls. Not all foot scaling in children, pruritic or not, is associated with dermatophytes. Dermatophytes may be present on the apparently healthy feet of children.
Asunto(s)
Arthrodermataceae/aislamiento & purificación , Dermatomicosis/diagnóstico , Dermatomicosis/microbiología , Dermatosis del Pie/diagnóstico , Dermatosis del Pie/microbiología , Niño , Preescolar , Estudios Transversales , Dermatomicosis/complicaciones , Femenino , Humanos , Hiperhidrosis/complicaciones , Masculino , Estudios Prospectivos , ZapatosRESUMEN
We show the records about diagnosed mycoses in a hospital in Mexico City in two periods of time: from 1967 to 1977 and from 1993 to 1997. In the former 15,429 patients were studied and in the latter, 5,998. Striking differences among frequency, etiological agents and clinical outcome, were observed. The most frequent infections in both lapses were the superficial ones, however the most recent scores showed a notorious increase in opportunistic infections. We diagnosed only one histoplasmosis case during the period from 1993 to 1997. Etiological agents have also changed, dermatophytes frequency like Trichophyton mentagrophytes and T. tonsurans have diminished while T. rubrum increased from 60
to 80
of the whole dermatophytoses cases. Even though Criptococcus neoformans used to be the only agent causing criptococosis, in the most recent report we found that C. laurentii, C. terreus and C. unigutulatus were also isolated. Another important difference was mortality in rhinocerebral mucormicosis: twenty years ago it was fairly 80
, nowadays it has decreased to 20
.
RESUMEN
We report the first, as far as we know, Mexican case of meningitis caused by Cryptococcus neoformans var. gattii serotype B associated with AIDS in a female patient. The HIV was transmitted to the patient through a blood transfusion. This patient represents, worldwide, the ninth case of C. neoformans var. gattii in patients with AIDS.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/microbiología , Criptococosis/etiología , Cryptococcus neoformans/aislamiento & purificación , Infecciones Oportunistas Relacionadas con el SIDA/epidemiología , Adulto , Criptococosis/complicaciones , Criptococosis/epidemiología , Cryptococcus neoformans/clasificación , Resultado Fatal , Femenino , Infecciones por VIH/etiología , Humanos , México , Reacción a la TransfusiónRESUMEN
A retrospective study of 20 patients with cryptococcal meningitis and their isolated strains was performed. Cryptococcus neoformans var. neoformans was recovered from 14 (70%) cases, and var. gattii was recovered from six (30%) patients. Twelve patients had AIDS (all carrying var. neoformans), two had other diseases (one with var. neoformans and one var. gattii) and there was no identifiable underlying disease in six (one var. neoformans and five var. gattii). Fourteen patients (11 var. neoformans and three var. gattii) resided in the Mexico City area, where a temperate climate is prevalent, and there were six cases (three var. neoformans and three var. gattii) from states with a tropical/subtropical climate. Although there was no significant statistical difference between the two varieties, the fatal outcome was higher in patients with var. neoformans. The disease caused by var. gattii strains was characterized by a higher opening pressure, more inflamatory changes of CSF and a longer clinical course (delayed clinical and mycological cure). Cryptococcus neoformans var. gattii is a significant cause of cryptococcal meningitis in patients without underlying diseases in Mexico.