Swallowing Rehabilitation of Children with Neurocrytococcosis—Case Report

Introduction: Cryptococcosis is a disease caused by Cryptococcus neoformans that injuring the lungs and the central nervous system. The involvement of the cerebral cortex and brainstem can cause dysphagia, whose rehabilitation in the pediatric population requires daily monitoring and constant parental guidance.

Objective: To describe the swallowing rehabilitation of a patient with neurocrytococcosis. Resume/Report: The patient with 3 years remained a month in the intensive care unit and 5 months in the pediatric ward. We observed alterations in lingual tonicity and lingual mobility, pathological reflex bite, alterations of oral motor during swallowing of saliva, delay of swallowing triggering time, and laryngeal aspiration. The indirect therapy was done twice daily with thermal, gustatory, and tactile stimulation. After 15 days, the direct therapy was done with thickened liquids associated with passives exercises to increase the strength of the tongue and removal of pathological reflex bite. The nasogastric tube was removed after 32 sessions of speech therapy and the child began to feed orally with soft solids and liquids without thickeners.

Conclusion: The swallowing rehabilitation of this patient was long. It was necessary collaboration of the multidisciplinary team and parents. The increased frequency of indirect therapy was essential to increase frequency of swallowing saliva with a significant reduction of the delay of swallowing triggering time.