American histoplasmosis in developing countries with a special focus on patients with HIV: diagnosis, treatment, and prognosis

Couppié, Pierre; Aznar, Christine; Carme, Bernard; Nacher, Mathieu

doi:10.1097/01.qco.0000244049.15888.b9

Cited by 105 publications

(134 citation statements)

References 48 publications

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“…This finding agrees with the pattern of AIDS distribution in the Colombian population (36). Such a tendency has been reported in other series as well (2,3,7,(17)(18)(19)23).…”

Section: Diagnostic Methodssupporting

confidence: 83%

Histoplasmosis en Colombia: resultados de la encuesta nacional, 1992-2008

et al. 2011

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Introduction. Histoplasmosis, a fungal disorder characterized by a wide spectrum of manifestations that range from subclinical infections to disseminated processes, affects both immunocompetent and immunosuppressed individuals. Histoplasmosis is not a reportable disease in Colombia and consequently, a survey was designed to collect histoplasmosis cases diagnosed in the country. Objective. The aim of this work was to analyze the data collected from 1992 to 2008. Materials and methods. The survey included demographic data, risk factors, clinical manifestations, imaging data, diagnostic methods and antifungal treatment. Patients were grouped according to risk factors and comparisons of the various findings were done. Results. A total of 434 surveys were gathered from 20 of the country's Departments. Most patients (96.1%) were adults, 77% were males with a mean age of 38.4 years. Only 3.9% were children less than 15 years of age. In the adult population, AIDS was reported in 70.5% of the cases; additionally, in 7.0% patients other immunosuppressive conditions were informed. The most frequent clinical manifestations were fever (76.1%), cough (54.8%) and constitutional symptoms (56.8%). X rays abnormalities were represented mainly by infiltrates (65.9%) and nodules (17.1%). Diagnosis was made by microscopic observation of H. capsulatum in 49.6% patients, by culture in 58.0% and by serological test in 14.6% cases. Antifungal use was recorded in 52.5% cases. Conclusions. Histoplasmosis is frequent in Colombia, especially in certain risk factor groups such as the HIV-infected population. Data collected from this large number of cases has allowed valid comparisons on various aspects of histoplasmosis in Colombia.Key words: histoplasmosis, surveillance, acquired immunodeficiency syndrome, children, disseminated histoplasmosis, Colombia. Author contributions:Myrtha Arango played an important role in the development of the project, revised the questionnaires and ascertained their completeness, participated in the analysis of the data and in the writing process. Elizabeth Castañeda conceived the plan for the surveillance program, orchestrated connections with hospitals, diagnostic centers and worked all along the development of the study, including writing and analyzing the manuscript. Clara Inés Agudelo worked all along in the surveillance study, played an important role in preparation of the manuscript and in analysis of the data, including statistical tests. Catalina De Bedout was in charge of the mycologic diagnosis for all CIB cases, established links with physicians in charge of patients, and controlled receipt of questionnaires. Carlos A. Agudelo was the physician in charge of most of the CIB patients, checked the questionnaire's contents for medical accuracy, and analyzed the data statistics. Ángela María Tobón examined many of the CIB patients, filled in the corresponding questionnaires, supervised the clinical aspects of most patients, and served as a consultant for other physicians in charge of histoplasmosis patie...

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“…This finding agrees with the pattern of AIDS distribution in the Colombian population (36). Such a tendency has been reported in other series as well (2,3,7,(17)(18)(19)23).…”

Section: Diagnostic Methodssupporting

confidence: 83%

Histoplasmosis en Colombia: resultados de la encuesta nacional, 1992-2008

et al. 2011

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“…6 In the present study, after adjusting for CD4 cell counts, we found no significant difference in LDH levels between persons with tuberculosis and those Ferritin concentration has also been described as an indicator for the diagnosis of severe disseminated histoplasmosis. 25 However, because of a large number of missing values, this variable was not selected for multivariate analysis.…”

Section: Discussionmentioning

confidence: 45%

“…Rapid and sensitive antigenic detection techniques are not available in most countries. 6 The non-specific nature of the clinical, biologic, histologic, and radiologic findings for these two diseases makes differential diagnosis of histoplasmosis difficult in disease-endemic areas. Thus, numerous publications report cases of histoplasmosis mimicking tuberculosis, most often because of the absence of diagnostic facilities or because a diagnosis of histoplasmosis was not considered.…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis and Histoplasmosis among Human Immunodeficiency Virus–Infected Patients: A Comparative Study

Adenis¹,

Nacher²,

Hanf³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. In disease-endemic areas, histoplasmosis is the main differential diagnosis for tuberculosis among human immunodeficiency virus (HIV)-infected patients. However, no study has compared the two diseases. Thus, the objec- . Tuberculosis and histoplasmosis have similarities, but some factors show a greater association with one of these diseases. Thus, adapted therapeutic choices can be made by using simple clinical and paraclinical criteria.

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“…Thus, it is important to improve the description of the presentation of these pathologies and to develop better diagnostic tools to aid the therapeutic decisions of the clinicians. 6 In the meantime, a better knowledge of what causes AIDS in the region is precious because we strongly suspect histoplasmosis is a major but unrecognized cause of numerous deaths in and around the Amazon.…”

mentioning

confidence: 99%