Inquérito intradérmico com histoplasmina e paracoccidioidina em duas regiões do Rio Grande do Sul

Abstract

Entre agosto e outubro de 1992, realizou-se estudo de prevalência de Intradermorreação com histoplasmina e paracoccidioidina nas cidades de Cachoeira do Sul (Vale do Rio Jacuí) e Santo Ângelo (Encosta Ocidental do Planalto), Rio Grande do Sul, Brasil. O teste cutâneo foi aplicado em 193 soldados em Cachoeira do Sul e 161 soldados de Santo Ângelo, ambos grupos com idade entre 17 e 19 anos. Em Cachoeira do Sul a prevalência de testes positivos para o histoplasmina foi de 89% e para a paracoccidioidina foi de 82%. Em Santo Angelo 48% das reações intradérmicas foram positivas para histoplasmina e 39% para paracoccidioidina.

Risk Factors for Death in Acquired Immunodeficiency Syndrome–associated Disseminated Histoplasmosis

“…2 A study performed in southern Brazil using the histoplasmin skin test showed that 89% of reactors were young men between 17 and 19 years of age. 3 Comparison of AIDS-disseminated histoplasmosis patients from the United States and Brazil showed more frequent skin involvement (1-7% versus 66%) and death (5-13% versus 19%) in the Brazilian patients. 4 The infection is characterized by a wide spectrum of manifestations ranging from asymptomatic illness to severe disseminated histoplasmosis.…”

“…6 Laboratory findings such as a serum creatinine level > 2.1 mg/dL and an albumin level < 3.5 g/dL have been associated with an increased risk of severe manifestations such as septic shock, respiratory failure, and death. 2 A prospective study among HIV-positive patients with disseminated histoplasmosis found that dyspnea, a platelet count < 100,000/mm 3 , and a lactate dehydrogenase (LDH) level > 2 times the normal upper limit were independent risk factors for death. 7 Better knowledge of the factors associated with high mortality in patients with disseminated histoplasmosis would result in better treatment.…”

Histoplasmose pulmonar aguda no Rio Grande do Sul

“…Many factors indicate that Rio Grande do Sul is a hyperendemic region for histoplasmosis, as are other regions of the country. Such factors include the types of histoplasmosis cases found, the fact that the acute pulmonary form was seen, the presence of isolated cases and cluster outbreaks, isolation of the etiologic agent in the soil (19) , the strong cutaneous reactivity to histoplasmin (20) , the large number of cases of the disseminated form in patients with acquired immunodeficiency syndrome (21) , the presence of the acute disseminated disease in infants (22) , and the presence of the chronic pulmonary form (21) . …”

Histoplasmose pulmonar cavitária crônica simulando tuberculose

“…(8) In Case 2, a four-month long investigation in a tertiary-care hospital did not result in an etiologic diagnosis, despite the fact that an invasive approach, fiberoptic bronchoscopy with transbronchial biopsy, was employed. Some explanations for that are that the biopsy sample was not submitted to special staining (with silver methenamine according to the Grocott-Gomori technique), which is crucial for the visualization of minor fungal elements, nor was the bronchoalveolar lavage material submitted to culture are recognizably endemic for histoplasmosis, presenting high rates of histoplasmin skin test positivity (93% and 89%, respectively), (14)(15) and the fungus can be easily isolated from the soil. (16)(17) A hypothetical diagnosis of CPH should be considered for patients with chronic obstructive pulmonary disease and exacerbation of symptoms whose epidemiologic history indicates the handling of soil contaminated with chicken droppings or bat guano.…”