Banca de DEFESA: Waleriano Ferreira de Freitas

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : Waleriano Ferreira de Freitas
DATE: 02/12/2022
TIME: 14:30
LOCAL: Remoto - Microsoft Teams
TITLE:

Epidemiology and management of patients with cryptococcosis in the Federal District, Brazil

KEY WORDS:

Cryptococcosis; meningitis; AIDS.

PAGES: 119
BIG AREA: Ciências da Saúde
AREA: Medicina
SUBÁREA: Clínica Médica
SPECIALTY: Doenças Infecciosas e Parasitárias
SUMMARY:

Introduction: Cryptococcosis is an infectious disease caused by fungi of the genus Cryptococcus recognized as an important threat to the health of people with cellular immunity deficiency, with potentially fatal cases of meningitis in AIDS patients, being in this population, the third most opportunistic infectious disease prevalent. Latin America is the third global region with the most cases and deaths from cryptococcosis, with an in-hospital case fatality ranging from 30 to 60%. In Brazil, cryptococcosis is the main systemic and opportunistic mycosis associated with deaths in AIDS patients. This yeast is acquired via inhalation and can cause infection in animals and humans, with the ability to infect all organs of the body, from the skin, lungs, and CNS. Neurological involvement requires early recognition and specialized management, especially in the face of intracranial hypertension. Antifungal therapy directed at the pathogen is usually performed with amphotericin B, 5-flucytosine, or fluconazole. Medications such as corticosteroids, acetazolamide or mannitol are not suitable for the management of intracranial hypertension, and this must be controlled with CSF drainage either by lumbar puncture or CSF shunts. Methods: Observational, analytical, descriptive, and retrospective study of the historical cohort type, with the main objective of knowing the epidemiological profile of patients with cryptococcosis in the Federal District and the determinants of lethality in the federal capital from 2014 to 2019. Secondary data extracted from medical records were used. of patients with cryptococcosis in this period. The inclusion criteria established patients from the public health system of the Federal District of Brazil with any positive sample for fungi of the genus Cryptococcus. Patient screening was performed using data obtained from the Central Laboratory of Brasilia or from the laboratory of the University Hospital of Brasilia. Sociodemographic and clinical variables were evaluated. Results: 100 patients were evaluated, with a mean age of 40.1 +/- 17 years, with most patients between 19 and 60 years. Males represented 70% of patients and Cryptococcus neoformans was the most prevalent species. The CNS was affected in 89% of the cases and co-infection with HIV was identified in 66% of the patients in the study, with marked immunosuppression as shown by the median CD4 of 49 cells/mm3. The diagnosis of intracranial hypertension occurred in 41% of the participants with a median opening pressure of 33.5 cm H2O, however the opening pressure was not evaluated in 44% of the patients. Lethality at 2 and 10 weeks was 26.9% and 38.7%, respectively. Conclusion: Cryptococcosis represents a major challenge for public health, given the costs of management, the priority involvement of people of working age, lack of knowledge of professionals regarding the diagnosis and treatment of cryptococcosis and its complications.

BANKING MEMBERS:
Presidente - 2901079 - ANDRE MORAES NICOLA
Interno - 2279074 - GUSTAVO ADOLFO SIERRA ROMERO
Externa à Instituição - MARCELA DE FARIA FERREIRA
Externo à Instituição - ERNANE PIRES MACIEL