Papulöses Exanthem bei systemischer Histoplasmose und HIV-Infektion

Abstract

A 34-year-old HIV-infected African woman developed fever, weight loss and widespread papules on her trunk, arms and face. Skin biopsy and culture revealed histoplasmosis caused by Histoplasma capsulatum varietas capsulatum (American histoplasmosis). Even though antimycotic treatment and intensive care were started immediately the patient died because of the systemic mycosis within a few days. Histoplasmosis is a rare disease in Europe but endemic in some areas of the USA (e.g., Ohio, Mississippi) and of Africa. Additionally histoplasma capsulatum varietas duboisii is endemic in Central and South Africa.

Histoplasmosis in patients living with HIV in Europe: review of literature

“…After deduplication, 1,215 articles were included; 1,106 articles were excluded by reading the title and the abstract only, not meeting the pre-defined inclusion criteria. At the end of the review process, 65 articles were included (52 case reports and 13 case series, with additional 37 cases) ( Dietrich et al, 1987 ; Smith et al, 1989 ; Rockstroh et al, 1991 ; Boulard et al, 1994 ; Manfredi et al, 1994 ; Wockel et al, 1994 ; Hofman et al, 1995 ; Trylesinski et al, 1995 ; Eichmann and Schär, 1996 ; Grosse et al, 1997 ; Angius et al, 1998 ; Schöfer and Baur, 1998 ; Guex, 1999 ; Knapp et al, 1999 ; Rieg et al, 1999 ; Antinori et al, 2000 , 2006 ; Farina et al, 2000 , 2005 ; Bilkenroth and Holzhausen, 2001 ; Rivasi et al, 2001 ; Carey et al, 2002 ; Molina et al, 2002 ; Rickerts et al, 2002 ; Calza et al, 2003 ; Lo Cascio et al, 2003 ; Crommentuyn et al, 2004 ; Faggian et al, 2004 ; Terrancle de Juan et al, 2004 ; Ferry et al, 2005 ; Matulionyte et al, 2005 ; Buhk et al, 2006 ; Gil-Brusola et al, 2007 ; Loulergue et al, 2007 ; Albrecht et al, 2008 ; Débat Zoguéreh et al, 2008 ; Peppa et al, 2008 ; De Lavaissière et al, 2009 ; Norman et al, 2009 ; Pellaton et al, 2009 ; Ala-Kauhaluoma et al, 2010 ; Pineau et al, 2010 ; Borges-Costa et al, 2011 ; Bourgeois et al, 2011 ; Inojosa et al, 2011 ; Navascués et al, 2011 ; Vaid and Patel, 2011 ; Carena Smuckler et al, 2012 ; Escher et al, 2012 ; Scarlata et al, 2012 ; Sharma et al, 2012 ; Navarro et al, 2013 ; …”

“…CDC staging at HIV diagnosis was reported for 60 (55%) patients: all were at stage C3 of the CDC classification except two patients that were at stage B3 ( Schöfer and Baur, 1998 ; Knapp et al, 1999 ). When reported (84 patients), the median time elapsed between HIV diagnosis and Histoplasma infection was 3 months [IQR 0–48].…”

Keratitis due toHistoplasmaspp. in a horse

“…Infection is usually acquired by inhalation of conidia, but ingestion or wound infection with infective conidia are also supposed 37,38 . H. capsulatum is endemic in tropical areas throughout much of the world, especially, in parts of the USA, West Indies, Central and South America, Africa, India and the Far East 39,40 . Although infection with H. capsulatum is not endemic in Europe, a few apparently autochthonous cases have been described in humans and wild badgers 39,41–44 .…”

“…39,40 Although infection with H. capsulatum is not endemic in Europe, a few apparently autochthonous cases have been described in humans and wild badgers. 39,[41][42][43][44] H. capsulatum seems to grow best in humid regions and in soils having high nitrogen content, especially those enriched with bird manure or bat droppings. The organism can be carried on the wings, feet, and beaks of birds and infect soil under roosting sites or manure accumulations inside or outside buildings.…”

“…H. capsulatum is endemic in tropical areas throughout much of the world, especially, in parts of the USA, West Indies, Central and South America, Africa, India and the Far East 39,40 . Although infection with H. capsulatum is not endemic in Europe, a few apparently autochthonous cases have been described in humans and wild badgers 39,41–44 . H. capsulatum seems to grow best in humid regions and in soils having high nitrogen content, especially those enriched with bird manure or bat droppings.…”