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Revista do Instituto de Medicina Tropical de São Paulo

On-line version ISSN 1678-9946

Rev. Inst. Med. trop. S. Paulo vol.33 no.6 São Paulo Nov./Dec. 1991

http://dx.doi.org/10.1590/S0036-46651991000600009 

SEROLOGY

 

Deteccion de antigeno del polisacarido capsular de Cryptococcus neoformans en pacientes con SIDA y neurocriptococosis en São Paulo, Brasil(1)

 

Detection of capsular polysaccharide antigen of Cryptococcus neoformans in patients with AIDS and neurocryptococcosis

 

 

B. CalvoI; O. FischmanI; A. Castelo FilhoI; J. Reis FilhoI; R. Del BiancoII; R.M. BarbosaIII; L. ZarorI

IDisc. Biologia Celular y Enfermedades Infecciosas y Parasitarias de Escola Paulista de Medicina, São Paulo, SP, Brasil
IIHospital Emílio Ribas, São Paulo, SP, Brasil
IIIHospital Servidor Público Estadual "Francisco Morato de Oliveira". São Paulo, SP, Brasil

 

 


RESUMEN

Antígeno del polisacárido capsular (Ag PC) de Cryptococcus neoformans fue detectado por la técnica de aglutinación de latex (AL) en LCR y suero de pacientes con Sindrome de Inmunodeficiencia Adquirida (SIDA) y primer episodio de neurocriptococosis, usando como patrón el examen micológico (examen directo y cultivo) de LCR. Se obtuvo una sensibilidad del 100% de AL para detectar AgPC de C. neoformans, el cual por su rápidez permite tratamiento específico precoz. Títulos iniciales de AgPC de la levadura en esos pacientes pueden ser > 1.000.000, pareciendo que cuando esos títulos están presentes en suero, se relacionan con mortalidad durante el tratamiento. En los pacientes que sobrevivieron se observó que el examen micológico directo y AgPC de C. neoformans, en LCR y suero, permanecen positivos aún después de tratamiento y mejoría clínica del paciente.

Unitermos: Cryptococcus neoformans; Antigeno del polisacarido capsular, SIDA; Neurocriptococosis.


SUMMARY

Capsular polysaccharide antigen (AgPC) of Cryptococcus neoformans was detected by latex agglutination technique (LA) in cerebrospinal fluid and serum of patients with AIDS during their first central nervous system manifestation of the disease. Direct mycological examination and culture were used as controls. Sensitivity was 100% by LA allowing an early specific treatment of cryptococcosis. Initial titres of AgPC in such patients can be > 1000000 and it appears that when such titres are present in the serum they are related to mortality during treatment. Surviving patients showed positivity of the direct mycological examination and AgPC of C. neoformans in cerebrospinal fluid and sera even after treatment and clinical recovery.


 

 

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Recebido para publicação em 23/06/1989.
Aceito para publicação em 19/08/1991.

 

 

(1) Parte de la tesis "Antígeno capsular, variedades y serotipos de Cryptococcus neoformans en pacientes con Sindrome de Inmunodeficiencia Adquirida y neurocriptococosis, São Paulo, Brasil", 1988, presentada para optar al título de Master en Enfermedades Infecciosas y Parasitarias de Escola Paulista de Medicina, São Paulo, por B. CALVO.

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