Study of 30 cases of histoplasmosis observed in the Mato Grosso do Sul State, Brazil

Chang, Marilene Rodrigues; Taira, Cleison Ledesma; Paniago, Anamaria Melo Miranda; Taira, Deborah Ledesma; Cunha, Rivaldo Venâncio da; Wanke, Bodo

doi:10.1590/s0036-46652007000100007

Cited by 34 publications

(36 citation statements)

References 11 publications

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“…Febrile splenomegaly and cytopenia in HIV-infected patients may also be observed in tuberculosis 26 , histoplasmosis 8 and lymphoma 23 . Cytopenias are frequent during the course of HIV infection and may result from several mechanisms 24 .…”

Section: Discussionmentioning

confidence: 98%

Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil

Cavalcanti

Medeiros

Lopes

et al. 2012

Rev. Inst. Med. trop. S. Paulo

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HIV/AIDS-associated visceral leishmaniasis may display the characteristics of an aggressive disease or without specific symptoms at all, thus making diagnosis difficult. The present study describes the results of diagnostic tests applied to a series of suspected VL cases in HIV-infected/AIDS patients admitted in referral hospitals in Pernambuco, Brazil. From a total of 14 eligible patients with cytopenias and/or fever of an unknown etiology, and indication of bone marrow aspirate, 10 patients were selected for inclusion in the study. Diagnosis was confirmed by the following examinations: Leishmania detection in bone marrow aspirate, direct agglutination test, indirect immunofluorescence, rK39 dipstick test, polymerase chain reaction and latex agglutination test. Five out of the ten patients were diagnosed with co-infection. A positive direct agglutination test was recorded for all five co-infected patients, the Leishmania detection and latex agglutination tests were positive in four patients, the rK39 dipstick test in three, the indirect immunofluorescence in two and a positive polymerase chain reaction was recorded for one patient. This series of cases was the first to be conducted in Brazil using this set of tests in order to detect co-infection. However, no consensus has thus far been reached regarding the most appropriate examination for the screening and monitoring of this group of patients.

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Section: Discussionmentioning

confidence: 98%

Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil

Cavalcanti

Medeiros

Lopes

et al. 2012

Rev. Inst. Med. trop. S. Paulo

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“…In the case of PDH associated with HIV, the need for straightforward and inexpensive laboratory diagnostic tools remains important, because PDH can cause death in 95% of cases (21) misdiagnosed. Delayed antifungal treatment of PDH results in mortality rates between 30 and 42% (22)(23)(24)(25)(26) in regions where the disease is endemic and where there are underserved populations or limited diagnostic resources. Molecular diagnostic tests have the potential to detect very small amounts of DNA with high specificity, and the LAMP method is both rapid and inexpensive.…”

Section: Discussionmentioning

confidence: 99%

Development of a Loop-Mediated Isothermal Amplification Method for Detection of Histoplasma capsulatum DNA in Clinical Samples

et al. 2014

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c Improved methods for the detection of Histoplasma capsulatum are needed in regions with limited resources in which the organism is endemic, where delayed diagnosis of progressive disseminated histoplasmosis (PDH) results in high mortality rates. We have investigated the use of a loop-mediated isothermal amplification (LAMP) assay to facilitate rapid inexpensive molecular diagnosis of this disease. Primers for LAMP were designed to amplify the Hcp100 locus of H. capsulatum. The sensitivity and limit of detection were evaluated using DNA extracted from 91 clinical isolates of known geographic subspecies, while the assay specificity was determined using DNA extracted from 50 other fungi and Mycobacterium tuberculosis. Urine specimens (n ‫؍‬ 6) collected from HIV-positive individuals with culture-and antigen-proven histoplasmosis were evaluated using the LAMP assay. Specimens from healthy persons (n ‫؍‬ 10) without evidence of histoplasmosis were used as assay controls. The Hcp100 LAMP assay was 100% sensitive and specific when tested with DNA extracted from culture isolates. The median limit of detection was <6 genomes (range, 1 to 300 genomes) for all except one geographic subspecies. The LAMP assay detected Hcp100 in 67% of antigen-positive urine specimens (4/6 specimens), and results were negative for Hcp100 in all healthy control urine specimens. We have shown that the Hcp100 LAMP assay is a rapid affordable assay that can be used to expedite culture confirmation of H. capsulatum in regions in which PDH is endemic. Further, our results indicate proof of the concept that the assay can be used to detect Histoplasma DNA in urine. Further evaluation of this assay using body fluid samples from a larger patient population is warranted.

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“…8 In developing countries and in some regions of the United States that include resource-poor areas, high mortality rates are reported for PLWHA who have progressive disseminated histoplasmosis (PDH). [9][10][11][12][13][14][15][16][17][18][19][20] For these reasons, health-care providers should be aware of the incidence of histoplasmosis in Colombia, and consider the possibility of this diagnosis in PLWHA patients with clinically compatible illness.…”

Section: Introductionmentioning

confidence: 99%

“…5,8,21,22 Histoplasmosis is a common and important public health problem in these susceptible populations. [9][10][11][12][13][14][15][16][17][18][19][20] The aim of this study was to identify a clinical and laboratory profile associated with histoplasmosis in PLWHA that could allow early suspicion of the disease, reducing the time to diagnosis and thus the disease's high mortality rate.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Laboratory Profile of Persons Living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and Histoplasmosis from a Colombian Hospital

Cáceres

Tobón

Cleveland

et al. 2016

The American Journal of Tropical Medicine and Hygiene

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Abstract. Histoplasmosis is common among persons living with human immunodeficiency virus/acquired immune deficiency syndrome (PLWHA) in Latin America, but its diagnosis is difficult and often nonspecific. We conducted prospective screening for histoplasmosis among PLWHA with signs or symptoms suggesting progressive disseminated histoplasmosis (PDH) and hospitalized in Hospital La María in Medellín, Colombia. The study's aim was to obtain a clinical and laboratory profile of PLWHA with PDH. During 3 years (May 2008 to August 2011), we identified 89 PLWHA hospitalized with symptoms suggestive of PDH, of whom 45 (51%) had histoplasmosis. We observed tuberculosis (TB) coinfection in a large proportion of patients with PDH (35%), so all analyses were performed adjusting for this coinfection and, alternatively, excluding histoplasmosis patients with TB. Results showed that the patients with PDH were more likely to have Karnofsky score ≤ 30 (prevalence ratio [PR] = 1.98, 95% confidence interval [CI] = 0.97-4.06), liver compromised with hepatomegaly and/or splenomegaly (PR = 1.77, CI = 1.03-3.06) and elevation in serum of alanine aminotransferase and aspartate aminotransferase to values > 40 mU/mL (PR = 2.06, CI = 1.09-3.88 and PR = 1.53, CI = 0.99-2.35, respectively). Using multiple correspondence analyses, we identified in patients with PDH a profile characterized by the presence of constitutional symptoms, namely weight loss and Karnofsky classification ≤ 30, gastrointestinal manifestations with alteration of liver enzymes and hepatosplenomegaly and/or splenomegaly, skin lesions, and hematological alterations. Study of the profiles is no substitute for laboratory diagnostics, but identifying clinical and laboratory indicators of PLWHA with PDH should allow development of strategies for reducing the time to diagnosis and thus mortality caused by Histoplasma capsulatum.

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Study of 30 cases of histoplasmosis observed in the Mato Grosso do Sul State, Brazil

Cited by 34 publications

References 11 publications

Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil

Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil

Development of a Loop-Mediated Isothermal Amplification Method for Detection of Histoplasma capsulatum DNA in Clinical Samples

Clinical and Laboratory Profile of Persons Living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and Histoplasmosis from a Colombian Hospital

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