A Twenty-First-Century Perspective of Disseminated Histoplasmosis in India: Literature Review and Retrospective Analysis of Published and Unpublished Cases at a Tertiary Care Hospital in North India

Gupta, Ayush; Ghosh, Arnab; Singh, Gagandeep; Xess, Immaculata

doi:10.1007/s11046-017-0191-z

Cited by 29 publications

(46 citation statements)

References 58 publications

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“…The high rate of HIV-infected patients found in this study is in agreement with data from other Latin American countries (Arango et al, 2011;Vantilcke et al, 2014), Asia (Gupta et al, 2017), and Europe (Antinori et al, 2006), demonstrating the strong relationship between HIV and histoplasmosis co-infection.…”

Section: Discussionsupporting

confidence: 93%

“…A significant increase was observed from the 1980s onwards, after the rise in HIV/AIDS cases, mainly of the disseminated form, giving histoplasmosis a prominent place among fungal diseases seen in this country (Ferreira and Borges, 2009). This study revealed a high incidence of histoplasmosis in middle-aged persons and a predominance of the disease among males, factors that were also observed in studies conducted in China, India, and Panama (Gutierrez et al, 2005;Pan et al, 2013;Gupta et al, 2017). The male predominance can be explained by the fact that HIV is more prevalent in males than females in Brazil (Damasceno et al, 2013).…”

Section: Discussionsupporting

confidence: 75%

“…The overall mortality rate observed in these Brazilian reported cases, where these data were available, was 33.1%. This mortality rate is higher than those described in previous reviews from China and India (Pan et al, 2013;Gupta et al, 2017), but lower than those observed in a study conducted in French Guiana involving HIV patients . It is difficult to differentiate mortality between HIV and non-HIV co-infected patients, because this information is missing for 36.5% of the publications.…”

Section: Discussioncontrasting

confidence: 71%

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The occurrence of histoplasmosis in Brazil: A systematic review

Almeida

Almeida-Silva

Guimarães

et al. 2019

International Journal of Infectious Diseases

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Background: Histoplasmosis is a systemic disease caused by the dimorphic fungus Histoplasma capsulatum. Diagnosis is often delayed, or it is misdiagnosed as tuberculosis. In Brazil, the infection is common and cases of histoplasmosis have been described in all regions of the country; however, the real problem is underestimated since notification of histoplasmosis is not mandatory. Methods: Human histoplasmosis cases diagnosed in Brazil and published up to December 2018 were identified through a search conducted in the PubMed/MEDLINE, SciELO, and Web of Science databases. Moreover, the isolation of H. capsulatum from animals or environmental sources in Brazil was also evaluated. Results: A total of 207 articles fulfilled the inclusion criteria and were evaluated, involving a total of 3530 patients with a diagnosis of histoplasmosis during the period studied. Of these patients, 78.3% were male, giving a male-to-female ratio of approximately 4:1. Histoplasmosis presented a higher frequency in individuals between the fourth and fifth decades of life. Disseminated disease was the most common form of histoplasmosis. Isolation of H. capsulatum on culture media and histopathology using staining methods were the diagnostic methods with the best efficiency. The best results in the identification of the H. capsulatum were achieved for samples from mononuclear phagocyte system components, skin and mucosa, and hematological samples. Regarding predisposing factors for histoplasmosis, HIV infection was the most common underlying condition. The overall mortality rate was 33.1%. Conclusions: This study represents the first available systematic review demonstrating Brazilian cases of histoplasmosis in the literature and highlights that the disease is more widespread in the Brazilian territory than has previously been thought.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 75%

Section: Discussioncontrasting

confidence: 71%

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The occurrence of histoplasmosis in Brazil: A systematic review

Almeida

Almeida-Silva

Guimarães

et al. 2019

International Journal of Infectious Diseases

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“…The soil of the Ganges River has been shown to harbour spores of H capsulatum . Due to reasons which are currently unclear, the last 15 years have seen a sharp increase in case reports and small series of patients with PDH from different parts of India . This includes patients from regions previously not known to be endemic for the disorder .…”

Section: Introductionmentioning

confidence: 99%

“…Due to reasons which are currently unclear, the last 15 years have seen a sharp increase in case reports and small series of patients with PDH from different parts of India . This includes patients from regions previously not known to be endemic for the disorder . In a recent study of 37 Indian patients with PDH, adrenal involvement was common, being reported in 38% of subjects…”

Section: Introductionmentioning

confidence: 99%

Clinical outcomes and cortical reserve in adrenal histoplasmosis—A retrospective follow‐up study of 40 patients

Singh

Chandy

Bharani

et al. 2019

Clinical Endocrinology

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Objective: Detailed studies of Addison's disease resulting from disseminated adrenal histoplasmosis (AH) are not available. We describe the presentation and prognosis of AH and cortisol status before and after antifungal therapy.Design: Single-centre retrospective hospital-based study of 40 consecutive adults with AH [39 males; age (mean ± SD) 53 ± 11 years] was conducted between 2006 and 2018. The median duration of follow-up was 2.5 years (range 0.2-12 years). Patients and methods: AH was diagnosed by bilateral adrenal enlargement on CT scan and presence of Histoplasma by histology and/or culture of biopsied adrenal tissue. All patients received oral itraconazole and, if required, amphotericin B as per guidelines. ACTH-stimulated serum cortisol (normal > 500 nmol/L) was measured in 38 patients at diagnosis and re-tested after one year of antifungal therapy in 21 patients. Results: Seventy-three per cent of patients had primary adrenal insufficiency (PAI) and one-third had an adrenal crisis at presentation. HIV antibody was negative in all patients. Of the 29 patients who completed antifungal therapy, 25 (86%) were in remission at last follow-up. Overall, 8 (20%) patients died: three had a sudden death, four had severe histoplasmosis and one died due to adrenal crisis. No patient with PAI became eucortisolemic on re-testing after one year of antifungal therapy. Of the eight patients with normal cortisol at diagnosis, two developed adrenal insufficiency on follow-up.Conclusion: All patients with AH tested negative for HIV antibody. While patients achieved a high rate of clinical remission after antifungal therapy, overall mortality was significant. Cortisol insufficiency did not normalize despite treatment. K E Y W O R D SAddison's disease, adrenal insufficiency, cortisol, histoplasmosis | 535 SINGH et al.

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Epidemiology of Endemic Mycoses in Asia

Chakrabarti

2019

Clinical Practice of Medical Mycology in Asia

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A Twenty-First-Century Perspective of Disseminated Histoplasmosis in India: Literature Review and Retrospective Analysis of Published and Unpublished Cases at a Tertiary Care Hospital in North India

Abstract: Disseminated histoplasmosis is being increasingly recognized in India. There is a need to undertake well-designed, analytical studies utilizing appropriate diagnostic modalities to understand the epidemiology of this neglected disease in proper perspective.

Cited by 29 publications

References 58 publications

The occurrence of histoplasmosis in Brazil: A systematic review

The occurrence of histoplasmosis in Brazil: A systematic review

Clinical outcomes and cortical reserve in adrenal histoplasmosis—A retrospective follow‐up study of 40 patients

Epidemiology of Endemic Mycoses in Asia

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