- CRIPTOCOCOSIS -

Santa Cruz, 10 de noviembre de 2023

Fernando Molina Lino
Medico internista - Infectologo
Fuente: WHO fungal priority pathogens list to guide research, development and public health action 2022
Fuente: WHO fungal priority pathogens list to guide research, development and public health action 2022
Fuente: WHO fungal priority pathogens list to guide research, development and public health action 2022
 Tabla de Contenido

01 02 03
Etiologia Epidemiologia Inmunopatología

04 05 06
Desafíos y
Clasificación de Tratamiento
formas clínica Recomendaciones
 Introducción
Hay 19 especies criptocócicas con dos
especies patogénicas principales, C.
neoformans y C. gattii
 01
Etiologia
 Etiología
• El género Cryptococcus comprende 19 especies

• Variedad de levaduras encapsuladas

• Dos especies patogénicas principales, C. neoformans y C. gattii

• Sigue habiendo casos esporadicos de infecciones en los seres

humanos con varias de estas especies no neoformans y no gattii,
como Cryptococcus albidus y Cryptococcus laurentis
 02
Epidemiologia
 Epidemiologia
• Se ha estimado su incidencia anual entre 1/5.000 y 1/50.000 dependiendo de la
zona geográfica.

• Los pacientes inmunodeprimidos son los principales afectados.

 Epidemiologia
• C. neoformans no suele considerarse un constituyente habitual de la flora
microbiologica humana.

• Cuando C neoformans se aisla de muestras clinicas no esteriles, el medico

debe buscar signos de enfermedad o factores de riesgo para su desarrollo
antes de planear estrategias terapeuticas adicionales.
 Realidad en Bolivia

Enfermedad Enfermedad necesita

subdiagnosticada? de notificación?

Cual es su incidencia Bolivia? Mortalidad en

Bolivia?
 03
Inmunopatología
La patogenia de la criptococosis está determinada por tres factores generales:

1) Estado de las defensas del huésped

2) Virulencia de la cepa de C. neoformans y C. gattii
3) Tamaño del inoculo.
Criptococosis se considera una enfermedad de reactivación
 04
Clasificación de Formas
Clínicas
 Diagnostico

Antigeno Serologia/Antigeno Imagen

Flujo lateral, Aglutinación en Inmunodifusion, Fijacción Radiografia de torax,
latex, Inmunoanalisis del complemento Tomografia
enzimatico

Cultivo Molecular Citopatologia

Cultivo Micologico: LCR, Estudios reciente en PCRt Tinta china - Mucicarmin
LBA, HMC.
Histopatologia
Histopatologia
Histopatologia
Histopatologia
Imagen
Antigeno
 05
Tratamiento
 Tratamiento
1. Anfotericina B
2. Fluconazol
3. 5-Fluorocitosina
Tratamiento
Tratamiento
 06
Desafío y Recomendaciones
 Recomendaciones y desafíos

1. Se necesitan más estudios para saber la incidencia y morbimortalidad en nuestro país.

2. Estos estudios deben abordar las regiones más afectadas.
3. Se debe conocer más sobre las pruebas diagnósticas y ser más accesible para el diagnóstico
diferencial.
4. Se desconoce la resistencia a los antifúngicos.
5. Se deben analizar realizar notificacion obligatoria para las enfermedades fúngicas en
nuestra región.
MUCHAS GRACIAS……..
 Identifying Information

Mars Jupiter Saturn

Despite being red, Mars It’s a gas giant and the Saturn is the ringed one.
is a very cold place, not biggest planet in our It’s composed mostly of
hot Solar System hydrogen
 Patient Medical History
2005
Jupiter is a gas giant and the
biggest in our Solar System

2008
Despite being red, Mars is a very
Age cold place, not hot
25

Gender Female 2012

Saturn is the ringed one. It’s
Location Madrid, Spain composed of hydrogen
Awesome
Words
 Systems’ Review

Mars Mercury
Despite being red, Mars is a Mercury is the closest to the
cold place. The planet is full Sun and the smallest one in
of iron oxide dust the Solar System

Jupiter Saturn
Jupiter is a gas giant and the Saturn is the ringed one. It’s a
biggest planet in our Solar gas giant, composed mostly of
System hydrogen
 Physical Examination
Saturn
Saturn is the ringed one. It’s
composed of hydrogen

Mars
Despite being red, Mars is a
surprisingly cold place

Jupiter
It’s a gas giant and the biggest
planet
A Picture Is
Worth A
Thousand
Words
 Evolution

Mercury Venus
Mercury is the Venus has a nice
closest to the Sun name, but it’s hot

Mars Jupiter
To modify this graph, click on it, follow the link, change the data
and paste the new graph here, replacing this one.
Despite being red, It’s the biggest in the
You can see how to modify the graph here Mars is cold System
 Prevalence

10% 30%
Mercury is the Venus has a nice
closest to the Sun name, but it’s hot

25% 35%
Despite being red, Jupiter is the biggest
Mars is cold planet

To modify this graph, click on it, follow the link, change the
data and paste the new graph here, replacing this one. Learn
how to modify the graph here
 Discussion

Dr. Jenna Doe Dr. John James

“Despite being red, Mars is a cold place, “Jupiter is a gas giant and the biggest in
not hot. It’s full of iron oxide dust, which our Solar System. It’s the fourth-
give its reddish cast” brightest object in the sky”
150,000
Big numbers catch your audience’s attention
 Discussion Summary
Mercury is the closest planet to the Sun and the
smallest one in the Solar System—it’s only a
bit larger than our Moon. The planet’s name
has nothing to do with the liquid metal
 Comparison

Jupiter Mercury Venus Mars

No No Yes Yes

Yes Yes Yes Yes

Yes No Yes Yes

No Yes Yes No

No Yes Yes No
 Treatment

Mars
Despite being red, Mars is a
cold place full of iron oxide
dust
Jupiter
Jupiter is a gas giant and the
biggest planet in our Solar
System
 Patient Monitoring

Week 1 Week 2 Week 3 Week 4

Mercury is the Venus has a nice Saturn is mostly Mars is a very cold
smallest planet of name, but it’s terribly composed of planet despite being
them all hot hydrogen a red place
 Contraindications & Indications

● You can describe the treatment
contraindication here
● You can describe the treatment
contraindication here
● You can describe the treatment
contraindication here
● You can describe the treatment
indication here
● You can describe the treatment
indication here
● You can describe the treatment
indication here
 Post-Prevention
Mars
Despite being red, Mars
is a cold place

Jupiter Saturn
Jupiter is a gas giant Saturn is composed
and the biggest mostly of hydrogen

Mercury Venus
Mercury is the closest Venus has a nice name,
to the Sun but it’s hot
 9h 56m 23s
Is Jupiter's rotation period

333,000.000
Earths is the Sun’s mass

386,000 km
Is the distance between the Earth and the Moon
 Case Timeline

Day 2 Day 4
Venus has a very Jupiter is mostly
beautiful name made of hydrogen

Day 1 Day 3 Day 5

Mercury is the The Earth is a planet Despite being red,
closest to the Sun with life Mars is very cold
 References

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher
● AUTHOR (YEAR). Title of the publication. Publisher
● AUTHOR (YEAR). Title of the publication. Publisher
● AUTHOR (YEAR). Title of the publication. Publisher
● AUTHOR (YEAR). Title of the publication. Publisher
 Our Team

John James Jenna Doe Jane Patterson

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this person here this person here this person here
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