Is Deepunction Diseases?
(Tolurosis, European Blastomycois)
1. Etiology and epidemiology
Cryptococcosis is also known as the European Blastomycose mycosis caused by Cryptoccocus neoformans, a thick cystic yeast, has serotypes A, D (C. neoformans var. Neoformans) and B, C ( C.neoformans var. Gattii) causes disease in humans. Fungi grow in the soil, especially in pigeon droppings, fungal spores that escape from the dispersal vesicles that cause primary disease in the lungs (by inhalation) and often spread through the bloodstream to the brain, kidneys, skin and nervous.
Fungi can cause disease in humans and animals, occurring around the world
2. Clinical symptoms
Dermatitis: less common.
. Lesions usually appear in the legs, arms, and face. The damage is very diverse:
- Injury is an ulcer with a clear boundary, round or multi-bowed, in the middle of red-purple, surrounded by pink halo, fluid and pus underneath. The lesions may then spread and may eventually become necrotic and become superficial, chronic ulcers.
- Lesions are scattered granular papules, papules or erosions, usually in the middle of the concave, the ridge is high, often with pale black scales covered with sores with bloody, erupted, egg-like ulcers necrotic fish. But in people with HIV, the herpes lesions or molluscum contagiosum
- Pustular abscess lesions, scarring and bridge formation, wrinkled like acne cluster
Pneumonia: Fungi can enter the lungs when they are inhaled and cause pneumonia, then present with mild fever, cough, and discharge and are detected by X-ray.
Meningitis: Initially mild fever, headache, nausea, vomiting, dizziness, lightheadedness, dizziness. When the disease progresses, severe headache, stiffness, high fever, cognitive disorders, memory loss, sometimes spinal edema, cranial nerve palsy, edema, coma, and death.
In addition, mushrooms can cause peritonitis, retina, liver, and bone.
3. Diagnostic tests
3.1. Direct examination: staining with ink with fluid samples, pus from lesions or centrifugal residues of cerebrospinal fluid, marrow or skin biopsy stained with muciramine .. may show this yeast cell buds size 8- 12 mm thick, with a thick crust that can double the size of a yeast cell. Fungal cells are detected in the organization when stained with PAS or methinamin silver.
. Culture: fungi can grow when the specimen is on sabouraud or blood agar, at 370C, colonies grow after 1-3 weeks with iridescent surface, smooth, pale pink, many yeast cells with many small buds.
33. Histopathology: staining of PAS or mucicarmine shows granulomatous reactions to tissue, giant cells, lymphocytes, fibroblasts; have necrotic foci, large follicular yeast cells.
3.4. Immunology: latex agglutination reaction, ELISA / blood, cerebrospinal fluid.
4. Differential diagnosis: molluscum contagiosum, acne, sarcoidosis, pyoderma, tuberculosis, cancer and other systemic fungal diseases (diffuse histoplasmosis).
Often combined with amphotaricin B 5-fluorocystosin, can use fluconazole, itraconazole, ketoconazole. In particular, fluconazole is often used as tablets and injections to treat cryptococcosis causing meningitis in HIV-infected patients.
Patients need to visit specialized medical facilities for testing and treatment.
Attention not to self-treat leads to oily drug and digestive complications.
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