Florica Stăniceanu *, Sabina Zurac **, Adrian Streinu-Cercel ***
* Conf. dr. Florica Stăniceanu, UMF “Carol Davila”, șef Laboratornl de Anatomie Patologică, Spitalul Clinic Colentina, București
** Dr. Sabina Zurac, Laboratorul de Anatomie Patologică, Spitalul Clinic Colentina, București
*** Dr. Adrian Streinu-Cercel, șef lucrări UMF “Carol Davila”, medic primar șef secție Institutul de Boli lnfecțioase “Prof. dr. Matei Balș”, București
Abstract
Cryptococcus neoformans is an encapsulated saprophyte fungus that is rarely producing disease in immunocompetent persons; most often, for the occurrence of the disease, different grades of immunodepression are required: congenital immunopaties, HIV infection, citostatic treatment, corticotherapy, sarcoidosis, diabetus melitus. The immune response to the infection whith Cryptococcus neoformans implies the initial intervention of the polymorphonuclear leukocytes and, latter the macrophages. The HIV infected alveolar macrophages have normal phagocytic capacity and reduce fungicidal activity. The interaction between Cryptococcus neoformans and HIV is biunivocal. Cryptococcus neoformans induces the HIV production from HIV latent infected cells; there is important intrathecal active HIV replication.The most frequent form of cryptococosis is the meningeal one. The cryptococic meningitis has unspecific symptomatology; the occurrence of the disease in HIV infected persons is correlated with the immunodepression grade. The positive diagnosis is established by the identification of the Cryptococcus neoformans in the cerebrospinal fluid (CSF); if the number of the microorganisms is very low, the direct microscopic examination is negativ but the culturea are positive no matter how many germs are. The cryptococic pneumonia is the second localization as frequency in HIV infected patients. The establishment of the extension of the infection – especially the meningealdeterminations existence by lumbar puncture and the treatment are on debate in correlation with the immune status of the patient. If the immunodepression is severe, most frequent the disseminated cryptococosis (cryptococic
septicemia) occurs.