Histoplasmosis in immunocompetent individuals living in an endemic area in the Brazilian Southeast

Abstract

Introduction:The distribution of infection by Histoplasma capsulatum in Brazil is heterogeneous, and the number of cases affecting immunocompetent individuals is relatively small. This study reports the epidemiological and clinical data regarding histoplasmosis in non-immunosuppressed individuals. Methods: The study included only the immunocompetent patients with histoplasmosis who were diagnosed between 1970 and 2012 at a university hospital located in Ribeirão Preto, State of São Paulo, Brazil. Clinical and epidemiological data were collected retrospectively from the patient records. Results: Of the 123 patients analyzed, 95 had an active disease that manifested in the different clinical forms of histoplasmosis. Men were the predominant gender, and most patients resided in the Northeast of the State of São Paulo and in the nearby municipalities of the State of Minas Gerais. The risk factors for acquiring histoplasmosis and prolonged contact in a rural environment were recorded in 43.9% and 82.9% of cases, respectively. Smoking, alcoholism, and comorbidity rates were high among the patients with the chronic pulmonary and subacute/chronic disseminated forms of histoplasmosis. Many patients achieved clinical cure spontaneously, but 58.9% required antifungals; the disease lethality rate was 5.3%. Conclusions: Immunocompetent individuals manifested the diverse clinical forms of histoplasmosis over a period of 4 decades, revealing an additional endemic area of this fungal disease in the Brazilian Southeast.

Microbial Disease Spectrum Linked to a Novel IL-12Rβ1 N-Terminal Signal Peptide Stop-Gain Homozygous Mutation with Paradoxical Receptor Cell-Surface Expression

“…recrudescence, he was successfully managed with Itraconazole, following the updated guidelines (Wheat et al, 2007). Worth noting, in immunocompetent patients, histoplasmosis has been successfully managed using ketoconazole (Faiolla et al, 2013). Cases of disseminated histoplasmosis have been reported in individuals with IFN-γR1 deficiency (IMD27B; Zerbe and Holland, 2005), which indicates that the IFN-γ response is necessary for the control of histoplasmosis (Clemons et al, 2000).…”

“…Cases of disseminated histoplasmosis have been reported in individuals with IFN-γR1 deficiency (IMD27B; Zerbe and Holland, 2005), which indicates that the IFN-γ response is necessary for the control of histoplasmosis (Clemons et al, 2000). In Brazil, the number of reported cases of histoplasmosis is small, with male gender, HIV-1 infection, and rural environment being the main risks factors mentioned (Faiolla et al, 2013). All four our patients live in a rural environment, but only Case 2 had histoplasmosis.…”

Disseminated histoplasmosis in an immuno‐competent young male: Role of bone marrow examination in rapid diagnosis

“…Those who develop clinical manifestations are usually immuno‐compromised or are exposed to a high quantity of inoculum. Prolonged contact in a rural environment, smoking, and alcoholism may also contribute to histoplasmosis in immuno‐competent host …”

“…Those who develop clinical manifestations are usually immuno-compromised or are exposed to a high quantity of inoculum. Prolonged contact in a rural environment, smoking, and alcoholism may also contribute to histoplasmosis in immuno-competent host 3. Histopathology using stains for fungi, cultures, antigen detection, and serologic tests for Histoplasma-specific antibodies can all help make the diagnosis of disseminated histoplasmosis.…”

Histoplasmosis outbreak in Tamboril cave—Minas Gerais state, Brazil

“…Facing that, the health programs should develop to investigate fungus incidence, mostly on tropical areas as observed in Brazil [2,17]. Understating the possible fungus reservoir and the description of its endemic area, we can prevent disease transmission avoiding the infection [18].…”