Epidemiologic Surveys of Histoplasmin and Paracoccidioidin Sensitivity in Brazil

Abstract

We report here the results obtained in epidemiologic surveys of histoplasmosis and paracoccidioidomycosis carried out in Brazil using the histoplasmin and paracoccidioidin delayed hypersensitivity skin tests. Most of these data have not been previously published in scientific journals and are now reported here in two tables respectively concerning histoplasmosis (88 surveys) and paracoccidioidomycosis (58 surveys). The guidelines to be followed in surveys of this nature are also commented upon.<br>Inquéritos epidemiológicos com histoplasmina e paracoccidioidina no Brasil Esta publicação visa a tornar acessíveis os resultados obtidos em inquéritos epidemiológicos sobre histoplasmose e paracoccidioidomicose, realizados no Brazil, através das reações intradérmicas de histoplasmina e paracoccidioidina. Ela justifica-se porque os resultados aqui relacionados, em grande parte, não foram publicados em revistas científicas. Os resultados que conseguimos colecionar são apresentados nas tabelas: 1 _ sobre histoplasmose e 2 _ sobre paracoccidioidomicose. Ao todo são relacionados 88 inquéritos sobre histoplasmose e 58 sobre paracoccidioidomicose. No final da publicação são feitos comentários sobre os ítens a serem obedecidos em inquéritos desta natureza

Serology of paracoccidioidomycosis

“…PCM subclinical infection is defined as an asymptomatic infection caused by P. brasiliensis in normal individuals who live in an endemic area and prove reactive to the paracoccidioidin skin test [45]. Positive paracoccidioidin skin testing in health population may vary from 3.70% to 62.60%, depending on the kind of antigenic preparation [46]. In our previous study, using gp43 or a polysaccharide antigen (Fava Netto's antigen) as paracoccidioidin, 5% of healthy people reacted positively to both antigens [47].…”

Histoplasmin Survey in Hiv-Positive Patients: Results From an Endemic Area in Northeastern Brazil

“…Another serological survey by FAVA & FAVA NETTO (1998) carried out in two localities of Bahia (Northeast Brazil) and 29 Southeast areas of the country revealed histoplasmin reactivity in 13% to 19.6% and 3.0% to 93.2%, respectively 12 ; the highest positivity was recorded in the city of Angra dos Reis on the coast of Rio de Janeiro State. In the southwestern Amazon, a study conducted in three native communities (individuals aged one to > 40 years old) observed positive histoplasmin test rates that varied from 5.8% to 80.5% 4 .…”

“…Skin tests were subsequently performed by intradermally injecting 0.1 mL of histoplasmin antigen (HMIN) 9 , in a 1:1000 dilution 12 , into the inside of the left forearm of each selected individual 7 . HMIN is a metabolic antigen from the filamentous phase of H. capsulatum produced in-house, isolated from sputum of a case of chronic pulmonary histoplasmosis, (IPEC3356), in Rio de Janeiro provided by the Mycology Laboratory at FIOCRUZ -Rio de Janeiro.…”

“…Previously, another survey of several cities throughout the country identified a prevalence ranging from 2.60% to 61.50% in populations living in Northeast Brazil 12 . Studies from Ceará performed several decades ago indicated a high prevalence (23.6% to 61.5%) of infection in individuals from rural areas 9,11 .…”

Histoplasmoma pulmonar no Rio Grande do Sul

“…Em 2.411 necrópsias e 40.848 espécimes excisados cirurgicamente de vários sítios, foram encontrados 15 nódulos contendo H. capsulatum no pulmão 9 . Os trabalhos publicados demonstram que nódulos pulmonares têm como causa freqüente infecção por H. capsulatum, especialmente em locais que coincidem com zona endêmica (RS, RJ, MG, SP), apresentando reatividade cutânea elevada à histoplasmina 4 , isolamento do fungo no solo 10 14 20 e microepidemias relatadas 3 .…”