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Map of the Regions of Argentina: Centre comprising City of Buenos Aires (CABA), Córdoba, Santa Fe, Entre Ríos and Buenos Aires provinces; Northeast (NEA) comprising Formosa, Chaco, Corrientes and Misiones provinces; Northwest (NOA) comprising Jujuy, Salta, Tucumán, Santiago del Estero and Catamarca provinces; Cuyo comprising La Rioja, San Juan, San Luis and Mendoza provinces; and Patagonia comprising La Pampa, Río Negro, Neuquén, Chubut and Santa Cruz provinces. The prevalence was estimated using data from cryptococcosis notified in 2010 and population projections to June 30, 2010 obtained from INDEC (http://www.indec.gob.ar). The estimated prevalence values are expressed per 100,000 population. Genotypes were obtained from prospective multicentre study carried out in 2009. HIV rates were obtained from HIV/AIDS Bulletin, 2016 (http://www.msal.gob.ar). Map adapted from Instituto Geográfico Nacional (http://www.ign.gob.ar)
Source publication
Purpose of Review
Cryptococcal meningitis is the most common fungal infection of the central nervous system and the third most frequent neurological complication in AIDS patients. To understand the Argentinean epidemiology of cryptococcosis, several efforts have been made by the National Reference Laboratory in Clinical Mycology.
Recent Findings
I...
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Cryptococcosis, one of the most important systemic mycosis in the world, is caused by different genotypes of Cryptococcus neoformans and Cryptococcus gattii, which differ in their ecology, epidemiology, and antifungal susceptibility. Therefore, the search for new molecular markers for genotyping, pathogenicity and drug susceptibility is necessary....
Cryptococcosis by Cryptococcus gattii occurs mainly in immunocompetent hosts, however, during the last decades, a growing number of cases in immunocompromised individuals have been noticed around the world. This report presents epidemiological, clinical and outcome aspects of patients with cryptococcosis caused by this species from a non-endemic ar...
Cryptococcosis is a life-threatening fungal infection. New therapeutic approaches are necessary to combat cryptococcosis, as the currently available therapeutic protocols are expensive and generally result in deleterious side effects. Pyrifenox is an antifungal compound that affects phytopathogens by inhibiting the biosynthesis of ergosterol. In th...
Citations
... Four weeks later, secondary prophylaxis (fluconazole 200 mg/day) was set up with excellent clinical evolution (Fig. 3). 16 The first case of AIDS related to cryptococcosis in the formerly mentioned Muñiz Hospital was diagnosed in 1983. In the 1990s about 3 new cases were diagnosed weekly and in the last 5 years an average of 60 new patients have been diagnosed per year. ...
Background
Cryptococcosis is a severe universally distributed mycosis which mainly affects immunocompromised hosts. This mycosis is caused by yeasts of two species complex of the genus Cryptococcus: Cryptococcus neoformans and Cryptococcus gattii. Meningeal cryptococcosis is the most frequent clinical presentation of this disseminated mycosis. The oral mucosa involvement is extremely unusual.
Case report
We present a case of cryptococcosis with an unusual clinical form. The patient was assisted because she had an ulcerated lesion on the lingual mucosa. Encapsulated yeasts compatible with Cryptococcus were found in microscopic exams of wet preparations from lingual ulcer clinical samples obtained for cytodiagnosis and mycological studies. Cryptococcus neoformans (C. neoformans var. grubii VNI) was isolated in culture. This patient did not know her condition of HIV seropositive before the appearance of the tongue lesion.
Conclusions
The involvement of the oral mucosa is uncommon in this fungal infection, but is important to include it in the differential diagnosis in HIV positive patients.
... The epidemiology of cryptococcosis in Argentina has been previously described 2,9,18 , this disease being the second deep yeast infection in the country. Its prevalence in 2010 was estimated at 1.23 per 100 000 inhabitants and 4.2 per 1000 HIV-seropositive patients 18 . ...
... The epidemiology of cryptococcosis in Argentina has been previously described 2,9,18 , this disease being the second deep yeast infection in the country. Its prevalence in 2010 was estimated at 1.23 per 100 000 inhabitants and 4.2 per 1000 HIV-seropositive patients 18 . Moreover, the ecological niche of C. neoformans and C. gattii species complexes has been previously studied in Buenos Aires city and the Northeast region 5,19,21 . ...
... In this study, the isolates were most frequently obtained from men than from women, the average age of patients was 38 years, and HIV-seropositive was the most frequent underlying disease (78%) in agreement with previous studies 2, 18 . In connection with those results, national data showed that in 2010 the HIV-seropositive diagnosis was most frequent in men than in women, and the average age of people diagnosed with HIV during 2009-2011 was 35 years in men and 31 years in women 24 . ...
The aim of this work was to know the frequency and geographical distribution of genotypes and mating types of Cryptococcus neoformans and Cryptococcus gattii species complexes isolated from human infections in Argentina during the period from April 2009 to April 2011. A multicenter study was conducted, in which 372 isolates were obtained from 61 laboratories throughout the country. Of those, 98.8% of the isolates belonged to the C. neoformans species complex and 1.1% to the C. gattii species complex. Genotype VNI (MATα) was the most frequently isolated (n=326, 87.6%), followed by VNII (MATα) (n=22, 5.9%), the recently described VNII-VNIV (aADα) hybrid (n=14, 3.8%), VNIV (MATα) (n=4, 1.1%), VNIII (αADa) hybrid (n=1, 0.3%), and VNIII (αADα) hybrid (n=1, 0.3%). The Argentine Central region showed the greatest number of cases and genotype diversity. Interestingly, a relative high frequency was observed in genotype VNII (MATα) in the Cuyo, Northeast and Northwest regions and, also in VNII-VNIV (aADα) hybrids in the Northwest region. C. gattii species complex was isolated at a low rate; 3 VGI (MATα) and 1 VGII (MATα) isolates were obtained from the Northwest and Central regions. In conclusion, this study shows that genotype frequencies seem to vary among regions in Argentina and reveals a relatively high frequency of rare hybrids in the Northwest region. Further regional clinical and environmental studies may help to elucidate if those variations in frequencies are associated with the existence of regional ecological niches or any other regional factors.
... Previous studies have reported the presence of C. gattii genotypes VGI, VGII, and VGIII in clinical and environmental sources in Argentina and other South American countries, but genotype VGIV has only been isolated in Colombia [10][11] . C. decagatti has been rarely isolated and with only 5 reports worldwide 3 . ...
We report the first case of cryptococcosis due to Cryptococcus decagattii in an immunocompetent pediatric patient from an indigenous community in Argentina with a successful outcome. Two isolates (blood, cerebrospinal fluid) were genotyped by restriction fragment length polymorphism of the orotidine monophosphate pyrophosphorylase (URA5) gene as VGIV and identified by multi-locus sequence typing as C. decagattii. Matrix-assisted laser desorption/ionization time of flight mass spectrometry identification indicated genotype VGIII. The minimum inhibitory concentration of amphotericin B, fluconazole, itraconazole, and voriconazole was determined (cerebrospinal fluid: 0.25, 16, 0.12, and 0.12, blood: 0.25, 4, 0.12, and 0.06, respectively, all in mg/L).
Cryptococcus neoformans and Cryptococcus gattii species complexes (phylum: Basidiomycota) are environmental yeasts and are the main cause of human cryptococcosis worldwide. The most recent molecular typing studies in Latin America have focused on the intertropical region. Thus, this study aimed to update the knowledge of human cryptococcosis in the South American temperate region. We obtained and analyzed 116 C. neoformans/C. gattii species complex isolates from the Public Health Surveillance Laboratory between 2008-2013 and 2017-2021 (C. gattii species complex = 1 and C. neoformans species complex = 115). The average patient age was 45 years, with an overall male:female ratio of 3.1:1. The proportion of HIV-negative patients was significantly higher in the second study period. Restriction fragment length polymorphism typing of URA5 revealed that the C. neoformans species complex comprised 75.7% VNI, 2.6% VNII, 0.9% VNIII, 1.7% VNIV, 17.4% VNII/VNIV hybrids and, one C. neoformans isolate (0.9%) misidentified as VGI; the C. gattii species complex isolates comprised one VGII. The overall case fatality rate was 49.5%, with no differences in lethality between VNI and hybrid isolates. Of the four isolates responsible for episodes of reoccurrence, only one had a genotype different from the first episode. Antifungal susceptibility testing revealed that most isolates fell below the local epidemiological cut-off value. This study provides additional information for the analysis of C. neoformans/C. gattii species complex dynamics in the South American temperate region.
