Neurocriptococose durante a gravidez: revisão da literatura. Relato de dois casos

Pereira, Carlos Alberto Pires; Fischman, Olga; Colombo, Arnaldo Lopes; Moron, Antonio Fernandes; Pignatari, Antonio Carlos Campos

doi:10.1590/S0036-46651993000400011

Resumos

São descritos os dois primeiros casos de neurocriptococose durante a gravidez diagnosticados em São Paulo (Brasil). Uma paciente foi tratada com anfotericina B no segundo trimestre, a outra, com anfotericina B no primeiro trimestre e no 2º trimestre com anfotericina B e 5 flucitosina. Ambas tiveram boa evolução materna e fetal. É apresentada revisão da literatura da neurocriptococose em gestantes.

Neurocriptococose; Gravidez; Anfotericina B; Flucitosina

Two cases of neurocryptococcosis were diagnosed during pregnancy in São Paulo (Brazil). Amphotericin B was used in the second trimester in one patient. The other, received amphotericin B during the first trimester of pregnancy and 5-fluorocytosine was added in the second trimester. In both, the pregnancy was uneventful and the fetus suffered no damage. The therapy used to treat pregnant women with cryptococcal meningitis is commented. The newborn follow-up is discussed. A review of the literature concerning neurocryptococcosis during pregnancy is presented.

REGISTRO DE CASO

Neurocriptococose durante a gravidez. Revisão da literatura. Relato de dois casos

Cryptococcal meningitis in pregnancy. Review of the literature. Report of two cases

Carlos Alberto Pires Pereira^I; Olga Fischman^II; Arnaldo Lopes Colombo^I; Antonio Fernandes Moron^III; Antonio Carlos Campos Pignatari^I

^IDisciplina de Doenças Infecciosas e Parasitárias da Escola Paulista de Medicina. São Paulo, SP, Brasil

^IIDisciplina de Biologia Celular, Setor de 'Micologia Médica da Escola Paulista de Medicina. São Paulo, SP, Brasil

^IIIDisciplina de Obstetrícia da Escola Paulista de Medicina. São Paulo, SP, Brasil

^{Endereço para correspondência} Endereço para correspondência: Carlos Alberto Pires Pereira Rua Napoleão de Barros, 715 - 1º andar Vila Clementino. CEP 04023-062 São Paulo, SP, Brasil Fone: 572-6348, Fax: (011) 572-6348 ou 549-2127

RESUMO

São descritos os dois primeiros casos de neurocriptococose durante a gravidez diagnosticados em São Paulo (Brasil). Uma paciente foi tratada com anfotericina B no segundo trimestre, a outra, com anfotericina B no primeiro trimestre e no 2º trimestre com anfotericina B e 5 flucitosina. Ambas tiveram boa evolução materna e fetal.

É apresentada revisão da literatura da neurocriptococose em gestantes.

Unitermos: Neurocriptococose; Gravidez; Anfotericina B; Flucitosina.

SUMMARY

Two cases of neurocryptococcosis were diagnosed during pregnancy in São Paulo (Brazil). Amphotericin B was used in the second trimester in one patient. The other, received amphotericin B during the first trimester of pregnancy and 5-fluorocytosine was added in the second trimester. In both, the pregnancy was uneventful and the fetus suffered no damage.

The therapy used to treat pregnant women with cryptococcal meningitis is commented. The newborn follow-up is discussed.

A review of the literature concerning neurocryptococcosis during pregnancy is presented.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Recebido para publicação em 20/10/1992

Aceito para publicação em 21/12/1992

Trabalho realizado na Escola Paulista de Medicina - Hospital São Paulo. Rua Botucatú, 740 - Vila Clementino. São Paulo, SP, Brasil.

1. AITKEN, G.W.E. & SYMONDS, E.L. - Cryptococcal meningitis in pregnancy treated with amphotericin B. J. Obstet. Gynaec., 62: 677-679, 1962.
2. BENNETT, J.E. - Flucytosine. Ann. intern. Med., 86: 319, 1987.
3. BRIGGS, G.G. - Flucytosine. In: BRIGGS, G.G. Drugs in pregnancy and lactation. 2.Ş ed. Baltimore, Williams & Wilkins, 1986. p. 184/f.
4. CHAUBE, S. & MURPHY, M. - The teratogenic effect of 5-fluorocytosine in the rat. Cancer Res., 29: 554, 1969.
5. CROTTY, J.M. - Systemic mycotic infection in Northern territory aborigines. Med. J. Aust., 1: 184-186, 1965.
6. CUROLE, D.N. - Cryptococcal meningitis in pregnancy. J. reprod. Med., 26: 317-319, 1981.
7. FELDMAN, R. - Cryptococcosis (Torulosis) of the central nervous system treated with amphotericin B during pregnancy. Sth. med. J. (Bgham. Ala.), 52: 1415-1417, 1959.
8. GANTZ, L.A.; NUETZEL, J.A. & KELLER, L.B. - Cryptococcal meningitis treated with amphotericin B. Arch. intern. Med., 102: 795-800, 1958.
9. ISMAIL, M.A. & LERNER, S.A. - Disseminated blastomycosis in a pregnant woman. Review of amphotericin B usage during pregnancy. Amer. Rev. resp. Dis., 126: 350-353, 1982.
10. KAUFFMAN, C.A. & FRAME, P.T. - Bone marrow toxicity associated with 5 fluorcytosine therapy. Antimicrob. Agents Chemother., 11: 244, 1977.
11. KUO, D. - A case of torulosis of the central nervous system during pregnancy. Med. J. Aust., 49: 558-559, 1962.
12. LACAZ. C. DA S. - Infecçőes por agentes oportunistas. In: LACAZ. C. da S., coord. Infecçőes por agentes oportunistas. Săo Paulo, Edgard Blücher; EDUSP, 1977. p. 5.
13. LITTMAN, M.L. - Cryptococcosis (Torulosis). Amer. J. Med., 26: 976-998, 1959.
14. LUTSKY, I. & BRODSH, J. - Experimental canine Cryptococcosis. J. infect. Dis., 114: 273-276, 1964.
15. MANDELL, G.L.; DOUGLAS, R.G. & BENNETT, J.E. - Cryptococcus neoformans. In: MANDELL, G.L.; DOUGLAS, R.G. & BENNETT, J.E. Principles and practices of infectious diseases. 3. ed. New York, John Wiley, 1989. p. 1980.
16. McCOY, M.J.; ELLENBERG, J.F. & KILLAN, A.P. - Coccidioidomycosis complicating pregnancy. Amer. J. Obstet. Gynec., 137: 739-740, 1980.
17. PHILPOT, C.R. & LO, D. - Cryptococcal meningitis in pregnancy. Med. J. Aust., 2: 1005-1007, 1972.
18. SCHONEBECH, J. & SEGERBRAND, E. - Candida albicans septicaemia during first half of pregnancy successfully treated with 5-fluorocytosine. Brit. med. J. clin. Res., 4: 337-338, 1973.
19. SILBERFARB, P.M.; SAROSI, G.A. & TOSH, F.E. - Cryptococcosis and pregnancy. Amer. J. Obstet. Gynec., 112: 714-720, 1972.
20. STAFFORD, C.R.; FISCHER, J.F. & FADEL, H.E. - Cryptococcal meningitis in pregnancy. Obstet. and Gynec., 62: 35S-37S, 1983.
21. TIMERNAN, H.J. - Fatal case of yeast meningitis in pregnancy. Amer. J. Obstet. Gynec., 31: 686, 1936.
22. WAGER, H.E. & CALHON, F.P. - Torula uveitis. Trans. Amer. Acad. Ophthal. Otolaryng., 58: 61, 1954.

Endereço para correspondência:

Carlos Alberto Pires Pereira

Rua Napoleão de Barros, 715 - 1º andar

Vila Clementino. CEP 04023-062 São Paulo, SP, Brasil

Fone: 572-6348, Fax: (011) 572-6348 ou 549-2127

Datas de Publicação

Publicação nesta coleção
21 Jul 2006
Data do Fascículo
Ago 1993

Histórico

Aceito
21 Dez 1992
Recebido
20 Out 1992

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. AITKEN, G.W.E. & SYMONDS, E.L. - Cryptococcal meningitis in pregnancy treated with amphotericin B. J. Obstet. Gynaec., 62: 677-679, 1962.

[2] 2. BENNETT, J.E. - Flucytosine. Ann. intern. Med., 86: 319, 1987.

[3] 3. BRIGGS, G.G. - Flucytosine. In: BRIGGS, G.G. Drugs in pregnancy and lactation. 2.Ş ed. Baltimore, Williams & Wilkins, 1986. p. 184/f.

[4] 4. CHAUBE, S. & MURPHY, M. - The teratogenic effect of 5-fluorocytosine in the rat. Cancer Res., 29: 554, 1969.

[5] 5. CROTTY, J.M. - Systemic mycotic infection in Northern territory aborigines. Med. J. Aust., 1: 184-186, 1965.

[6] 6. CUROLE, D.N. - Cryptococcal meningitis in pregnancy. J. reprod. Med., 26: 317-319, 1981.

[7] 7. FELDMAN, R. - Cryptococcosis (Torulosis) of the central nervous system treated with amphotericin B during pregnancy. Sth. med. J. (Bgham. Ala.), 52: 1415-1417, 1959.

[8] 8. GANTZ, L.A.; NUETZEL, J.A. & KELLER, L.B. - Cryptococcal meningitis treated with amphotericin B. Arch. intern. Med., 102: 795-800, 1958.

[9] 9. ISMAIL, M.A. & LERNER, S.A. - Disseminated blastomycosis in a pregnant woman. Review of amphotericin B usage during pregnancy. Amer. Rev. resp. Dis., 126: 350-353, 1982.

[10] 10. KAUFFMAN, C.A. & FRAME, P.T. - Bone marrow toxicity associated with 5 fluorcytosine therapy. Antimicrob. Agents Chemother., 11: 244, 1977.

[11] 11. KUO, D. - A case of torulosis of the central nervous system during pregnancy. Med. J. Aust., 49: 558-559, 1962.

[12] 12. LACAZ. C. DA S. - Infecçőes por agentes oportunistas. In: LACAZ. C. da S., coord. Infecçőes por agentes oportunistas. Săo Paulo, Edgard Blücher; EDUSP, 1977. p. 5.

[13] 13. LITTMAN, M.L. - Cryptococcosis (Torulosis). Amer. J. Med., 26: 976-998, 1959.

[14] 14. LUTSKY, I. & BRODSH, J. - Experimental canine Cryptococcosis. J. infect. Dis., 114: 273-276, 1964.

[15] 15. MANDELL, G.L.; DOUGLAS, R.G. & BENNETT, J.E. - Cryptococcus neoformans. In: MANDELL, G.L.; DOUGLAS, R.G. & BENNETT, J.E. Principles and practices of infectious diseases. 3. ed. New York, John Wiley, 1989. p. 1980.

[16] 16. McCOY, M.J.; ELLENBERG, J.F. & KILLAN, A.P. - Coccidioidomycosis complicating pregnancy. Amer. J. Obstet. Gynec., 137: 739-740, 1980.

[17] 17. PHILPOT, C.R. & LO, D. - Cryptococcal meningitis in pregnancy. Med. J. Aust., 2: 1005-1007, 1972.

[18] 18. SCHONEBECH, J. & SEGERBRAND, E. - Candida albicans septicaemia during first half of pregnancy successfully treated with 5-fluorocytosine. Brit. med. J. clin. Res., 4: 337-338, 1973.

[19] 19. SILBERFARB, P.M.; SAROSI, G.A. & TOSH, F.E. - Cryptococcosis and pregnancy. Amer. J. Obstet. Gynec., 112: 714-720, 1972.

[20] 20. STAFFORD, C.R.; FISCHER, J.F. & FADEL, H.E. - Cryptococcal meningitis in pregnancy. Obstet. and Gynec., 62: 35S-37S, 1983.

[21] 21. TIMERNAN, H.J. - Fatal case of yeast meningitis in pregnancy. Amer. J. Obstet. Gynec., 31: 686, 1936.

[22] 22. WAGER, H.E. & CALHON, F.P. - Torula uveitis. Trans. Amer. Acad. Ophthal. Otolaryng., 58: 61, 1954.

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