Hospitalizations for Endemic Mycoses: A Population-Based National Study

Chu, Jaclyn; Feudtner, Chris; Heydon, Kateri; Walsh, Thomas J.; Zaoutis, Theoklis E.

doi:10.1086/500405

Cited by 241 publications

(180 citation statements)

References 11 publications

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“…Nowadays, despite the increased use of highly active antiretroviral therapy (HAART), histoplasmosis remains an AIDS-defining illness. [10][11][12][13] The diagnosis of histoplasmosis is based on fungal isolation by culture or microscopic examination of the respiratory tract, biopsies, and body fluid specimens; however, laboratory assays only yield positive results in approximately 50% of cases. 3,5,14,15 Although culture is generally considered to be highly specific, it has several notable limitations, including low sensitivity, a need for invasive procedures in many cases, and delayed fungal growth (approximately 2-6 weeks).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Culture and Serological Tests in the Diagnosis of Histoplasmosis in HIV and non-HIV Colombian Patients

Arango-Bustamante¹,

Restrepo

Cano

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. We determined the value of culture and serological tests used to diagnose histoplasmosis. The medical records of 391 histoplasmosis patients were analyzed. Diagnosis of the mycosis was assessed by culture, complement fixation, and immunodiffusion tests; 310 patients (79.5%) were male, and 184 patients (47.1%) were infected with human immunodeficiency virus (HIV). Positivity value for cultures was 35.7% (74/207), reactivity of serological tests was 95.2% (160/168), and a combination of both methodologies was 16.9% (35/207) for non-HIV patients. Positivity value for cultures was 75.0% (138/184), reactivity of serological tests was 92.4% (85/92), and a combination of both methodologies was 26.0% (48/184) for HIV/acquired immunodeficiency syndrome (AIDS) patients; 48.1% (102/212) of extrapulmonary samples from HIV/AIDS patients yielded positive cultures compared with 23.1% (49/212) in non-HIV patients. Lymphocyte counts made for 33.1% (61/184) of HIV/AIDS patients showed a trend to low CD4+ numbers and higher proportion of positive cultures. These results indicate that culture is the most reliable fungal diagnostic method for HIV/AIDS patients, and contrary to what is generally believed, serological assays are useful for diagnosing histoplasmosis in these patients.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Value of Culture and Serological Tests in the Diagnosis of Histoplasmosis in HIV and non-HIV Colombian Patients

Arango-Bustamante¹,

Restrepo

Cano

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…The expanded use of immunosuppressive chemotherapies, and transplantation further increases the risk for both common and uncommon Candida species. In addition, as our aging population becomes increasingly mobile, environmental exposures to a variety of endemic fungal pathogens become more common and sometimes, may further increase the risk of fungal diseases (Xu et al, 1999;Samaranayake et al, 2003;Pfaller and Diekema, 2004;Walsh et al, 2004;Nucci, and Marr, 2005;Chu et al, 2006;Pfaller and Diekema, 2007). Other factors that have been associated with VC include: extensive use of broad spectrum antibiotics (Nasibwa et al, 1994), oral contraceptives (Baeten et al, 2001) and to a lesser extent corticosteroids and other immunosuppressive drugs (Baeten et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Diversity of Pathogenic Candida Species Colonizing Women with and without Candida Vaginitis in Dar es Salaam Region, Tanzania

Namkinga

2012

JBLS

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The aim of this study was to establish phenotypic and genetic diversities of Candida species isolated from women with recurrent Candida vaginitis. A total of 3000 samples were cultured from 3000 women with and without complaints of vaginal discharges and pruritis vulvae. Growth characteristics on Sabouraud's dextrose agar and on conidia enhancing media (Corn meal agar) resulted in isolation of 5440 distinct colonies of Candida species. They were then analyzed by germ tube test to separate C. albicans from non-albicans Candida species. For confirmation, 300 doubtful isolates were then tested on API 20C AUX and by polymerase chain reaction.The results showed Candida albicans species to be dominant 3661 (67.29%) while non-albicans Candida species presented only 1779 (32.71%) which included C. glabrata 435(8.0%), C. tropicalis 762(14.0%), C. krusei 163(3.0%), C. famata 109(2.0%), C. parapsilosis 131(2.41%), C. guilliermondii and C. lusitaniae each 27(0.5%) respectively, C. incospicua 13 (0.24%), C. norvegensis 82(1.5%), C. colliculosa 16 (0.3%) and C. magnoliae 15 (0.27%). On genotypic diversity, the principle coordinate analysis of the PCR results for the genetic relatedness and genetic distances revealed the distribution of 200 isolates tested as: C. albicans 90(36%), C. glabrata 40(20%), C. krusei 20 (10%), C. tropicalis 20 (10%), C. famata 10(5%), C. parapsilosis 5(2.5%), C. norvegensis 6(3%), C. lusitaniae 4(2%), and C. guilliermondii 5(2.5%).From this study it shows that a combination of biochemical methods and PCR technology may identify most of the isolates, including the germ tube negative isolates. Both symptomatic and asymptomatic women possessed similar species and genotypic diversities. However, in symptomatic women, a single host can be colonized with multiple species or multiple Journal of Biology and Life Science ISSN 2157-6076 2013 www.macrothink.org/jbls 154 genotypes of the same species. In order to establish if the same species behave differently in symptomatic and asymptomatic individuals, this study recommend further investigation on virulent factors.

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“…Disseminated histoplasmosis was later included in the list of opportunistic infection defining AIDS. Despite the increased use of highly active antiretroviral therapy (HAART), histoplasmosis remains an important opportunistic infection among HIV patients in endemic areas and frequently appears as the first manifestation of HIV infection or as the AIDS-defining illness (6)(7)(8)(9).…”

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confidence: 99%

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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Hospitalizations for Endemic Mycoses: A Population-Based National Study

Cited by 241 publications

References 11 publications

Diagnostic Value of Culture and Serological Tests in the Diagnosis of Histoplasmosis in HIV and non-HIV Colombian Patients

Diagnostic Value of Culture and Serological Tests in the Diagnosis of Histoplasmosis in HIV and non-HIV Colombian Patients

Diversity of Pathogenic Candida Species Colonizing Women with and without Candida Vaginitis in Dar es Salaam Region, Tanzania

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

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