Histoplasma capsulatum and Pneumocystis jirovecii coinfection in hospitalized HIV and non-HIV patients from a tertiary care hospital in Mexico

Abstract

Background: Histoplasma capsulatum and Pneumocystis jirovecii are respiratory fungal pathogens that principally cause pulmonary disease. Coinfection with both pathogens is scarcely reported. This study detected this coinfection using specific molecular methods for each fungus in the bronchoalveolar lavage (BAL) of patients from a tertiary care hospital. Materials and methods: BAL samples from 289 hospitalized patients were screened by PCR with specific markers for H. capsulatum (Hcp100) and P. jirovecii (mtLSUrRNA and mtSSUrRNA). The presence of these pathogens was confirmed by the generated sequences for each marker. The clinical and laboratory data for the patients were analyzed using statistical software. Results: The PCR findings separated three groups of patients, where the first was represented by 60 (20.8%) histoplasmosis patients, the second by 45 (15.6%) patients with pneumocystosis, and the last group by 12 (4.2%) patients with coinfection. High similarity among the generated sequences of each species was demonstrated by BLASTn and neighbor-joining algorithms. The estimated prevalence of H. capsulatum and P. jirovecii coinfection was higher in HIV patients.

Functional Nanocarriers for Delivering Itraconazole Against Fungal Intracellular Infections

“…This drug is commonly prescribed to patients with serious fungal infections such as histoplasmosis, an infection produced by the etiological agent H. capsulatum. This fungus, together with Pneumocystis spp, is currently associated with the development of coinfections in HIV-positive patients, whose presence in some geographical regions is even higher than that of bacteria such as M. tuberculosis ( Agudelo et al, 2012 ; Caceres et al, 2018 ; Carreto-Binaghi et al, 2019 ). By encapsulating ITZ in NPs, we expect to reduce the limitations related to its high lipophilicity and low absorption ability ( Ling et al, 2016 ; Alhowyan et al, 2019 ; Biswaro et al, 2019 ).…”

<p>HIV-Associated Histoplasmosis: Current Perspectives</p>

“…There are report cases of disseminated histoplasmosis mimicking extrapulmonary or miliary tuberculosis. 50 There are some reports of co-infection with other opportunistic infections such as tuberculosis, 51 Pneumocystis jirovecii 52 and cryptococcal infection. 53 In one cohort from Columbia, co-infection with other opportunistic infection was found in 51% of the patients with disseminated histoplasmosis.…”

Coinfecção entre HIV e Histoplasma capsulatum

“…Histoplasma capsulatum é termicamente ascomiceto dimórfico, exibindo a forma filamentosa (miceliana) com temperatura entre 20°C a 30°C e a forma leveduriforme em temperatura próxima de 37°C (Carreto-Binaghi et al, 2019;Kuate, Ekeng, Kwizera, Mandengue, & Bongomin, 2021). Esse patógeno possui duas variedades distintas: H. capsulatum var.…”

“…O H. capsulatum apresenta diversos fatores de virulência que favorecem a adesão fúngica, colonização, disseminação e habilidade para sobreviver a ambientes desfavoráveis driblando os mecanismos de defesa do sistema imunológico do hospedeiro. Um dos principais fatores de virulência de H. capsulatum é o dimorfismo, um aspecto considerável na patogênese da doença, visto que a forma filamentosa é a que garante a infecção e a forma leveduriforme a que parasita o homem causando a doença (Carreto-Binaghi et al,2019;Kuate et al, 2021).…”

“…capsulatum pode ser considerado um patógeno primário porque infecta pessoas saudáveis, embora também mostre um comportamento oportunista em indivíduos imunocomprometidos. O fungo tem o pulmão como porta de entrada e a doença pode se apresentar em apenas um sítio ou na forma disseminada (Carreto-Binaghi et al,2019).…”