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Kryptokokkose

Zuletzt geändert von Thomas Brinkmeier am 2025/04/25 21:42

Kryptokokkose

Engl: cryptococcosis

Def: opportunistische Mykose durch einen Hefepilz

Err: - Cryptococcus neoformans

- Cryptococcus gattii

Vork: - meist bei Immunsuppression (insbes. HIV)

- Prävalenz von 2,8% bei Pat. mit Z.n. Transplantation eines soliden Organs (Stand 2020)

Inf: Inhalation von Staub, der von kontaminiertem Taubenkot stammt (pulmonale Kryptokokkose)  

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Di: - Biopsie und PAS-Färbung

- Kryptokokkenantigen im Serum

- Sediment im Sammelurin

- Tuschepräparat aus Liquor bei Meningitis

- Kultur aus Sputum, Bronchialsekret, Biopsie, Liquor

HV: - typischerweise anfangs molluskoide Hautveränderungen

DD: finden sich auch bei einer anderen opportunistischen Mykose, der Penicillium-marneffei-Infektion

- später papulonekrotische Läsionen

Hi: PAS-positive rundliche Kryptokokken in Riesenzellen

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Kopl: - ZNS-Befall (Meningoenzephalitis)

- weiterer Organbefall (z.B. Haut, Herz, Augen, Skelett)

Lit: -  

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- JAAD Case Rep. 2020 Apr 29;6(5):388-389

- Acta Derm Venereol. 2020 May 25. http://doi.org/10.2340/00015555-3528

- Cartron, A. M, Challa, N., Chung, C., & Trinidad, J. C. (2020). Umbilicated papules on the bilateral upper and lower extremities. Dermatology Online Journal, 26(6). Retrieved from https://escholarship.org/uc/item/4wq4t095

Th: - Amphotericin B

Co: Flucytosin

Bed: Kombinationstherapie gilt als GS

Ind: Akutbehandlung

- Fluconazol

Ind: Anschlussbehandlung

  
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