Kriptokokosis Meningeal: Epidemiologi Berbasis Molekular, Manifestasi Klinis dan Luarannya

Abstract

Abstrak Cryptococcus sp. sebagai penyebab kriptokokosis meningeal telah banyak diteliti di dunia, tetapi epidemiologi molekular, manifestasi klinis, penegakan diagnostik dan luaran klinisnya belum dibahas secara komprehensif. Tujuh nama baru Cryptococcus sp. telah diusulkan dan berdasarkan hal itu penyebarannya bervariasi di beberapa negara. Cryptococcus. gattii masih lebih terbatas area penyebarannya dibandingkan C. neoformans. Keragaman genotipe dapat diperoleh baik dalam satu negara maupun pada satu pasien kriptokokosis meningeal. Manifestasi klinis yang mucul berbeda-beda, namun utamanya adalah sakit kepala, demam dan penurunan kesadaran. Prosedur diagnosis dapat dipilih mulai dari pemeriksaan konvensional hingga uji berbasis molekular dan protein. Luaran klinis dipengaruhi oleh beberapa faktor, diantaranya beban jamur, penyakit dasar, status imun pasien, diagnosis dini, serta ketersediaan obat.
Kata Kunci: Cryptococcus, kriptokokosis, spesies, aspek klinik.

Abstract Cryptococcus sp. as the cause of meningeal cryptococcosis had been widely studied around the world. But its molecular epidemiology with clinical manifestations, diagnostic procedures and clinical outcomes have not been comprehensively discussed. Seven new names for Cryptococcus sp. have been proposed and the distribution varies in several countries. However, C. gattii is still more restricted in area than C. neoformans. Genotype diversity was obtained in both one country and in one patient meningeal cryptococcosis. The clinical manifestations that appear are different, however the main ones are headache, fever and decreased consciousness. Diagnosis procedures could be carried out from conventional to molecular and protein-based. Clinical outcomes are influenced by several factors, including fungal load, underlying disease, patient’s immune status and early doagnosis as well as the availability of drugs.
Key words: Cryptococcus, molecular epidemiology, clinical aspects