RESUMO
BACKGROUND: Trichosporon species may colonize the skin, respiratory tract and gastrointestinal tract of human beings. The yeast is recognized as etiological agent of white piedra, a superficial mycosis. Nevertheless, immunocompromised hosts may develop invasive Trichosporonosis. Central nervous system trichosporonosis is a very rare clinical manifestation. In fact, only a few cases have been published in the literature and none of them was caused by Trichosporon inkin. CASE PRESENTATION: Here we report the first clinical case of meningoencephalitis due to this species in a female previously healthy patient under corticosteroids and antibiotics therapy for several months. She was submitted to an invasive procedure to remove a left sided acoustic neuroma and further developed a cerebrospinal fistula. After some days of the procedure, she presented a predominantly and intensive occipital holocranial headache, followed by vomiting, hyporexia, weight loss, asthenia, irritability, difficulty to concentrate and rotator vertigo. The patient further developed a cerebrospinal fistula in the occipital region and was submitted to a surgical correction. After several months of clinical interventions, she was diagnosed with CNS Trichosporonosis, after Magnetic Resonance Imaging and positive microbiological cultures obtained within two different occasions (2 weeks apart). Despite the antifungal therapy with Amphotericin B and Voriconazole, the patient did not survive. CONCLUSIONS: Despite CNS Fungal infections are mostly due to Cryptococcus spp., other emergent yeasts, such as T. inkin may be considered as a likely etiological agent. This is the first case report of CNS Trichosporonosis, where species identification was performed with rDNA sequencing.
Assuntos
Meningite Fúngica/tratamento farmacológico , Trichosporon/efeitos dos fármacos , Trichosporon/patogenicidade , Tricosporonose/tratamento farmacológico , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Brasil , DNA Ribossômico , Feminino , Humanos , Hospedeiro Imunocomprometido , Meningite Fúngica/diagnóstico , Meningite Fúngica/microbiologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Análise de Sequência de DNA , Trichosporon/genética , Tricosporonose/diagnóstico , Voriconazol/uso terapêuticoRESUMO
Cryptosporidiosis is a very prominent disease in the field of public health, and usually causes diarrhea. We describe two immunocompetent patients who presented with chronic diarrhea that was ultimately found to be caused by continuous exposure to well water contaminated with the microbial cysts (oocysts) of the Cryptosporidium spp parasite. We describe the patients' histories and possible explanations for their prolonged symptoms.
Assuntos
Criptosporidiose/transmissão , Abastecimento de Água , Água/parasitologia , Idoso de 80 Anos ou mais , Doença Crônica , Criptosporidiose/diagnóstico , Fezes/parasitologia , Feminino , Humanos , Hospedeiro Imunocomprometido , Masculino , Pessoa de Meia-IdadeRESUMO
Abstract: Cryptosporidiosis is a very prominent disease in the field of public health, and usually causes diarrhea. We describe two immunocompetent patients who presented with chronic diarrhea that was ultimately found to be caused by continuous exposure to well water contaminated with the microbial cysts (oocysts) of the Cryptosporidium spp parasite. We describe the patients' histories and possible explanations for their prolonged symptoms.