Browsing by Autor "E. Garcia"

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Cerebral cryptococcosis regarding two clinical cases and bibliographic review
(2024) E. Garcia; Rommer Alex Ortega Martínez
Cryptococcosis is a life-threatening infection, the species complexes Cryptococcus neoformans and Cryptococcus gattii are yeasts with a polysaccharide capsule, metabolize urea and catecholamines; It is transmitted by inhalation of bird droppings, mainly pigeons, and is capable of causing outbreaks in both immunocompromised and immunocompetent hosts. In Latin America, cryptococcal meningitis is a health threat. The initial infection is localized to the lungs and spreads to other organs, such as the central nervous system, where it causes meningoencephalitis and rarely focal granulomatous lesions such as cryptococcomas. The diagnosis must be made early, with serological tests for the cryptococcal polysaccharide capsular antigen. Treatment is divided into induction, consolidation and maintenance. Below, two clinical cases are presented, the first case is a 68-year-old female with a history of tuberculosis 15 years ago; 10 days, with holocranial headache, nausea and vomiting; on physical examination with superficial stupor, nuchal rigidity; kerning sign (+); lumbar puncture with identification of cryptococcal meningitis, induction treatment with fluconazole was started. The second case, a 60-year-old male with a history of acute lymphoblastic leukemia with chemotherapy 1 month ago, suddenly presented with altered consciousness, a lumbar puncture was performed, which reported cryptococcal meningitis by PCR, induction treatment with fluconazole was started; Both patients were admitted to the Intensive Care Unit, however, they had an unfavorable outcome
Cerebral meningitis due to tuberculoma and epstein barr: presentation of a clinical case
(2024) E. Garcia; Rommer Alex Ortega Martínez; Masziel Andrea Calle Vilca
Neuroinfection is an inflammatory process that affects the meninges or brain parenchyma; it has various etiologies, including viral and non-viral, including autoimmune, bacterial and fungal; patients with this pathology represent a challenge for doctors; the severity varies, from benign, self-limiting to life-threatening. The Epstein-Barr virus (EBV) is a double-stranded DNA gamma herpesvirus that presents a latent infection and lytic replication; it can diffuse into the central nervous system and alter the integrity of the blood-brain barrier, being associated with neurocognitive impairment, neuronal damage and inflammation. In relation to tuberculosis, it became the second infectious disease that caused the most deaths in the world after COVID-19; tuberculous meningitis is considered the most severe form of extrapulmonary tuberculosis (TB) with a mortality of 70% in low-income countries. Below is the case of a 35-year-old man with a history of adrenal insufficiency and hyperthyroidism, who was receiving corticosteroids; he went to the emergency service with a 5-month history of clinical symptoms characterized by holocranial headache, focal retrograde amnesia, periods of altered state of consciousness, dizziness, nausea that led to vomiting on several occasions, with sudden loss of consciousness. , accompanied by involuntary tonic-clonic movements and hearing loss; after the diagnostic screening, EBV and TB are identified; receives specific treatment with good clinical evolution