Mycopathologia

, Volume 133, Issue 2, pp 65–69 | Cite as

Cryptococcosis as an opportunistic infection in immunodeficiency secondary to paracoccidioidomycosis

  • Gil Benard
  • R. C. B. Gryschek
  • A. J. S. Duarte
  • M. A. Shikanai-Yasuda
Article

Abstract

We describe the case reports of two patients with immunodeficiency secondary to paracoccidioidomycosis (PCM) and opportunistic Cryptococcus neoformans infections. Secondary immunodeficiency likely occurred as a consequence of the intestinal loss of proteins and lymphocytes associated with malabsorption syndrome due to obstructed lymphatic drainage. Both patients had had severe abdominal involvement during the acute PCM disease. Immunological evaluation showed cellular and humoral immunity impairment. Cryptococcosis manifested as relatively well circumscribed lesions: osteolytic lesions of the skull in one patient, and pulmonary nodules in the other. The latter was treated surgically and with amphotericin B, whereas the other was treated with the combination amphotericin-B and flucytosine. Both patients had a good response to treatment with complete regression of the lesions. They have now 2 and 4 years of follow-up with maintenance therapy and no indication of reactivation of the infection. PCM also did not reactivate. The clinical and immunological characteristics of these patients are discussed and compared to the opportunistic C. neoformans infections of AIDS and transplant patients.

Key words

Cryptococcosis paracoccidioidomycosis secondary immunodeficiency malabsorption syndrome opportunistic infection 

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Copyright information

© Kluwer Academic Publishers 1996

Authors and Affiliations

  • Gil Benard
    • 1
  • R. C. B. Gryschek
    • 2
  • A. J. S. Duarte
    • 1
  • M. A. Shikanai-Yasuda
    • 2
    • 3
  1. 1.Immunogenetic and Experimental Transplantation LaboratoryUniversidade de São PauloBrazil
  2. 2.Infectious and Parasitic Diseases DepartmentUniversidade de São PauloBrazil
  3. 3.Laboratory of Medical Investigation in Immunology, Faculty of MedicineUniversidade de São PauloBrazil

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