Cryptococcal meningitis occurs when the introduction into the meninges yeast cryptococci. The infection affects mainly people with severely reduced immunity - this is one of the most frequent complications in AIDS patients, cancer patients after a course of chemotherapy and radiation therapy, and the patients have immune suppression in organ transplants.
Cryptococcal (blastomikozny) meningitis - Causes and infection
Cryptococcus yeast is very common in nature. The main focus of the spread is now considered bird droppings and nests, especially dangerous doves, flocks of which constantly live in the cities (the birds themselves do not get sick). Cryptococcus into the soil, mixed with the dust and fall into the bronchi and human lungs by inhalation of contaminated dust. It is believed that the disease from person to person is not transferred. Men get sick more often than women.
To onset, single ingestion of infection low, you should also decrease the body's defenses - immune system. The disease occurs at a deep immunodeficiency, when the CD4 count is less than 50-100 per ml. Lymphocytes CD4 (T-Heller, assistant) - a type of white blood cells responsible for the immune response to the introduction of infection - they activate cellular and humoral immunity.
That is why cryptococcal meningitis
Meningitis - an inflammation of the meninges
very often develops AIDS, and even one of the causes of death of these patients. The risk of infection Cryptococcus are cancer patients, people who have undergone organ transplants, as well as all patients receiving long-term glucocorticoid hormones - all of them have reduced immunity.
If you get a fungal infection in the bronchi and lungs there formed the primary focus of inflammation. Then, in the inflammatory process involves nearby lymph nodes. In the lesions formed granulomas (inflammation in the form of nodules) that can necrotic (Disintegrating) to form cavities. Of primary lesions bloodstream infection can get into the cranial cavity and cause meningitis.
Symptoms and characteristics of the course of cryptococcal meningitis
Pneumonic cryptococcal infection can occur in the form of bronchitis
Bronchitis - protection if the body has malfunctioned
, Pneumonia, and can completely asymptomatic. When immunodeficiencies cryptococcal infection can enter the bloodstream and spread to all the organs and tissues. Primarily affect the meninges and begins cryptococcal meningitis and meningoencephalitis. The vast majority of cases of cryptococcal meningitis reported in AIDS.
The disease develops gradually. The patient may be a little temperature rise (it may not be, but in rare cases, the temperature is high), periodic headaches (mainly headache in the forehead and temples), the intensity of which may increase, dizziness
Dizziness - if the ground is slipping from under his feet
, Blurred vision, irritability. Characterized by small seizures of Jacksonian type: against the clear consciousness of having spasms in some muscle or group of muscles limbs (usually the hand), or muscles of the face, followed by the spread of seizures on the same side limbs or facial muscles. Sometimes the cramps spread to the opposite side, and in some cases become generalized (common) character. They may also develop focal neurological symptoms (paresis, speech disorders, and so forth). In later stages of the disorder of consciousness can occur.
Cryptococcal meningitis occurs subacute and chronic. Chronic cryptococcal meningitis is sometimes the first manifestation of AIDS.
Diagnosis is based on detection of an infectious agent or antibodies to it in the cerebrospinal fluid (CSF), taken by a puncture. In addition, the diagnosis of cryptococcal confirmed by the presence in the cerebrospinal fluid lymphocytic pleocytosis - increased content of blood cells which make up the bulk of lymphocytes.
If you want to do magnetic resonance or computed tomography (CT or MRI) - this study may reveal focal processes in the brain, or hydrocephalus phenomenon (water on the brain).
Besides the usual pathogenetic (acting on the mechanisms of the disease) and symptomatic (relieving symptoms of meningitis) treatment of cryptococcal meningitis pi necessarily prescribe antifungal medications. The drug of choice is amphotericin B, moreover, are sometimes prescribed fluconazole
Fluconazole - used with caution
To prevent infection of people with reduced immunity is not necessary to sleep on feather pillows and down with the bird.