Histoplasmosis in Israeli Travelers

Segel, Michael J.; Rozenman, Judith; Lindsley, Mark D.; Lachish, Tamar; Berkman, Neville; Neuberger, Ami; Schwartz, Eli

doi:10.4269/ajtmh.14-0509

Cited by 15 publications

(9 citation statements)

References 22 publications

(21 reference statements)

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“…This systematic review of diagnoses of histoplasmosis made in Europe and Israel over 16 years identified 728 cases. Of those, 505 were described in five retrospective studies, including three studies of acute histoplasmosis in travellers diagnosed in Spain [13], Italy [15], and Israel [16]; one study of imported AIDS-related histoplasmosis conducted by the French National Reference Centre for Mycoses and Antifungals (NRCMA) [14]; and one summarising imported endemic mycoses (including histoplasmosis) in hospitalised patients in Spain [12]. The remaining 223 cases were retrieved from single case reports or small case series .…”

Section: Discussionmentioning

confidence: 99%

“…As shown in Table 1, five studies involving 505 subjects (295/436 males, 67.7%) described cumulative experiences of histoplasmosis: two from Spain (one regarding imported endemic mycoses from 1997 to 2014 [12], the other relating to histoplasmosis in Spanish travellers to Latin America [13]), a retrospective study from metropolitan France reporting all the cases of histoplasmosis in PLWH diagnosed between 1985 and 2006 [14], and two about cases of acute histoplasmosis diagnosed in travellers in a single centre in Italy between 2005 and 2015 [15] and in Israel between 2000 and 2012 [16].…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

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Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Antinori

Giacomelli

Corbellino

et al. 2021

JoF

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Human histoplasmosis is a mycosis caused by two distinct varieties of a dimorphic fungus: Histoplasma capsulatum var. capsulatum and H. capsulatum var. duboisii. In Europe, it is usually imported by migrants and travellers, although there have been some autochthonous cases, especially in Italy; however, most European physicians are unfamiliar with its clinical and pathological picture, particularly among immunocompromised patients without HIV infection. This systematic review of all the cases of histoplasmosis reported in Europe and Israel between 2005 and 2020 identified 728 cases diagnosed in 17 European countries and Israel described in 133 articles. The vast majority were imported (mainly from Central and South America), but there were also seven autochthonous cases (six in Europe and one in Israel). The patients were prevalently males (60.4%), and their ages ranged from 2 to 86 years. The time between leaving an endemic region and the diagnosis of histoplasmosis varied from a few weeks to more than 40 years. Progressive disseminated histoplasmosis was the most frequent clinical picture among people living with HIV infection (89.5%) or a different immunocompromising condition (57.1%), but it was also recorded in 6.2% of immunocompetent patients. Twenty-eight cases were caused by Histoplasma duboisii. Immunocompromised patients without HIV infection had the worst outcomes, with a mortality rate of 32%.

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Section: Discussionmentioning

confidence: 99%

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Antinori

Giacomelli

Corbellino

et al. 2021

JoF

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“…Since the risk of Histoplasma exposure in Europe is minimal, patients, who present with dyspnea, fever and malaise are not primarily considered for diagnosis of histoplasmosis. Remarkably however, in the recent series from Israel all cases of histoplasmosis were associated with travelling to endemic areas and visiting caves or other places inhabited by bats [3]. Thus, a thorough traveling history should be recommended in suspected individuals.…”

Section: Discussionmentioning

confidence: 99%

Histoplasmosis in an elderly Polish tourist – a case report

et al. 2019

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Background Histoplasmosis is a mycosis caused by soil-based fungus Histoplasma capsulatum endemic in the USA, Latin America, Africa and South-East Asia. The disease is usually self-resolving, but exposure to a large inoculum or accompanying immune deficiencies may result in severe illness. Symptoms are unspecific with fever, cough and malaise as the most common. Thus, this is a case of disease which is difficult to diagnose and very rare in Europe. As a result, it is usually not suspected in elderly patients with cough and dyspnea. Case presentation This is a case of a 78-year-old patient, admitted to our department due to respiratory failure, cough, shortness of breath, fever and weight loss with no response to antibiotics administered before the admission. Chest CT revealed numerous reticular and nodular infiltrations with distribution in all lobes. The cytopathology of BAL showed small parts of mycelium and numerous oval spores. Considering clinical presentation and history of travel to Mexico before onset of disease, pulmonary histoplasmosis was diagnosed. After introduction of antifungal treatment rapid improvement was achieved in terms of both clinical picture and respiratory function. Conclusions Since the risk of Histoplasma exposure in Europe is minimal, patients, who present with dyspnea, fever and malaise are not primarily considered for diagnosis of histoplasmosis. However, taking into account increasing popularity of travelling, also by elderly or patients with impaired immunity, histoplasmosis should be included into differential diagnosis.

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“…They accumulate up to 64.1% of the cases diagnosed in immunocompetent European travelers (Staffolani et al, 2018), and concentrate 66.4% of travel-related cases belonging to a cluster. Isolated cases have been communicated in several other European countries (Ashbee et al, 2008;Doleschal et al, 2016;Lindner et al, 2018) as well as in Asia (Cho et al, 2018) and the MiddleEast (Segel et al, 2015).…”

Section: Histoplasmosis In Non-endemic Countries: the Extent Of The Pmentioning

confidence: 99%

Timely Diagnosis of Histoplasmosis in Non-endemic Countries: A Laboratory Challenge

Buitrago

Martín-Gómez

2020

Front. Microbiol.

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Human histoplasmosis is a fungal infection caused by the inhalation of microconidia of the thermally dimorphic fungi Histoplasma capsulatum. Autochthonous cases of histoplasmosis have been diagnosed in almost every country, but it is considered an endemic infection in specific areas of the world. Many of them are popular travel destinations or the source of migratory movements. Thus, the vast majority of the registered cases in non-endemic countries are imported. They correspond to people having been exposed to the fungus in endemic locations as immigrants, expatriates, transient workers or tourists, with reported cases also associated to organ donation. Misdiagnosis and delays in initiation of treatment are not uncommon in cases of imported histoplasmosis. They are associated to high fatality-rates specially in patients with compromised cellular immunity in which progressive disseminated forms develop. The diagnosis of this infection in non-endemic countries is hampered by the lack of clinical suspicion and a dearth of available diagnostic tools adequate to offer rapid and accurate results. Non-culture-based assays such as nucleic-acid amplification tests present as a suitable alternative in this situation, offering improved sensitivity and specificity, shortened turnaround time, and increased biosafety by avoiding culture manipulation. In non-endemic regions, molecular techniques are being used mainly in laboratories from countries that have registered an increase in the incidence of imported cases. However, the number of published techniques is limited and lack consensus. Efforts are currently under way to standardize nucleic acid amplificationbased techniques for its implementation in areas registering a rising number of imported cases.

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Histoplasmosis in Israeli Travelers

Abstract: Abstract. Histoplasmosis is a common endemic human mycoses acquired mostly in the Americas. We reviewed 23 cases of histoplasmosis in Israeli travelers; 22 had traveled to Central or South America and one to North America.

Cited by 15 publications

References 22 publications

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Histoplasmosis in an elderly Polish tourist – a case report

Timely Diagnosis of Histoplasmosis in Non-endemic Countries: A Laboratory Challenge

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