Meningeal cryptococcosis in patients non infected with HIV: presentation of two cases and review of the literature Cryptococcosis is a fungal disease of global distribution with a higher incidence in developing countries, where it represents one of the main causes of meningitis, associated with high morbidity and mortality. It mainly occurs in patients with immunosuppression (due to HIV infection, glucocorticoid treatment, transplants, cancer, etc.). However, in recent years there has been an increase in cases in immunocompetent, which is as serious or more severe than in immunocompromised. We report two cases of cryptococcal meningitis. A 48-year-old male with no pathological history, in whom HIV infection or another cause of immunosuppression was ruled out, and a 67-year-old woman with a previous diagnosis of liver cirrhosis. The above mentioned highlights the importance of always considering Cryptococcus spp. as possible causative agent of meningitis, in both immunocompromised and immunocompetent patients.
La tuberculosis permanece como la enfermedad infecciosa que más muertes ha causado a lo largo de la historia de la existencia humana, sin poderse aún lograr su control. En años recientes ha emergido un cúmulo importante de evidencia clínica acerca de la función de la vitamina D (calcitriol o 1,25 hidroxivitamina D) en un papel que va más allá de la homeostasis del calcio. Su papel en el sistema inmunológico es muy interesante vinculando su déficit como un factor de riesgo contribuyente y así mismo fisiopatológico en un gran número de enfermedades autoinmunes e infecciosas. Dentro de éstas se destaca la tuberculosis, enfermedad endémica en nuestro país y en la cual el déficit de dicho compuesto (vitamina D) crea un factor de riesgo para desarrollar esta enfermedad en su forma activa. Presentamos una revisión detallada de los estudios que explican el papel de la vitamina D en la susceptibilidad para el desarrollo de tuberculosis y los resultados de los estudios clínicos de suplencia de la misma publicados a la fecha.
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