Cryptococcosis in HIV infection of man: an epidemiological and immunological indicator?
Cryptococcosis is an epidemiological and immunological indicator due to the absence of Cryptococcus neoformans as a saprophyte in immunocompetent humans and the advantage of specific C. neoformans culture. On this basis, a report is presented on the CD4 lymphocyte count of 36 AIDS patients suffering from cryptococcosis and other concomitant or missing opportunistic AIDS-defining infections. In 26 out of 36 patients, i.e. 72%, a CD4 lymphocyte count of < or = 50/microL (mean value 39.5%) was found. Cryptococcosis as the sole opportunistic infection was diagnosed in 5 cases (13.9%). In 31 cases, various combinations of AIDS-associated diseases were found: Pneumocystis carinii pneumonia (PCP) (n = 19), cytomegalovirus infection (CMV) (n = 10), Kaposi's sarcoma (n = 6), Mycobacterium avium intracellulare infection (MAI) (n = 5), pneumonia (n = 2), toxoplasmosis (n = 2), Candida esophagitis (n = 1), tuberculosis (n = 1), lambliasis (n = 1), salmonellosis (n = 1) and wasting syndrome (n = 5). The conspicuous simultaneous occurrence or succession of pneumocystosis and cryptococcosis and the contrasting absence of aspergillosis and mucormycosis (zygomycosis) are commented. Based on the present observations in HIV-infected persons in Berlin, a CD4 lymphocyte count of < 150/microL may be used as a parameter indicating a predisposition for cryptococcosis as an airborne AIDS-defining infection. Attention is drawn to bird droppings as the sole habitat of C. neoformans and accidental niche of various other microorganisms.
Arastéh
K
K
II. Innere Klinik, Auguste-Viktoria-Krankenhaus, Berlin, Germany.
Staib
F
F
Grosse
G
G
Futh
U
U
L'Age
M
M
D017088:AIDS-Related Opportunistic Infections / Q000276:immunology*; D018791:CD4 Lymphocyte Count; D002177:Candidiasis / Q000150:complications / Q000276:immunology; D003453:Cryptococcosis / Q000150:complications / Q000276:immunology*; D003455:Cryptococcus neoformans / Q000276:immunology*; D003586:Cytomegalovirus Infections / Q000150:complications / Q000276:immunology; D006801:Humans; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications / Q000276:immunology; D011020:Pneumonia, Pneumocystis / Q000150:complications / Q000276:immunology; D012514:Sarcoma, Kaposi / Q000150:complications / Q000276:immunology; D014123:Toxoplasmosis / Q000150:complications / Q000276:immunology