Brotes de histoplasmosis registrados en el área andina colombiana

Ordóñez, Nelly; Tobón, Ángela M.; Arango, Myrtha; Tabares, Angela; Bedout, Catalina de; Gómez, Beatriz L.; Castañeda, Elizabeth; Restrepo, Ángela

doi:10.7705/biomedica.v17i2.941

Cited by 13 publications

(19 citation statements)

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“…On the other hand, the ID test revealed precipitin bands in 74.2% of the patients that were tested, a figure lower that in non-compromised patients (85.7%). Similar findings had been previously presented by Tobón et al in a smaller series (32). Despite this promising result, a more extensive study aimed at evaluating the effectiveness on serologic tests in patients with various types of immunosuppression should be carried out.…”

Section: Diagnostic Methodssupporting

confidence: 79%

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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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Section: Diagnostic Methodssupporting

confidence: 79%

“…Nonetheless, the fact that it is not a reportable disorder hinders precise determination of its real incidence and impact on public health issues (29)(30)(31)(32)(33). Another important finding in the series was the predominance of male patients (77%) who had a mean age of 38.4 (±12.3) years, as previously reported (29)(30)(31).…”

Section: Diagnostic Methodssupporting

confidence: 58%

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

et al. 2011

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“…Como se mencionó anteriormente, la histoplasmosis es endémica en el continente americano y Colombia es considerada como área de alta prevalencia, a pesar de no ser una enfermedad de notificación obligatoria (8)(9)(10). De acuerdo con la frecuencia de pruebas reactivas a la histoplasmina en personas normales y a los informes sobre brotes, las zonas de mayor prevalencia están localizadas entre las cordilleras central y oriental (10)(11)(12).…”

Section: Discussionunclassified

“…Se han informado varios brotes de histoplasmosis primaria aguda en el país (cuadro 2). En ellos, se destaca la alta frecuencia de infección (45,3%) -demostrada por pruebas serológicas reactivas -en las personas expuestas que acompañaban al caso índice durante la actividad creadora de aerosoles (8)(9)(10). Igualmente, se anota que más del 80% de las muestras ambientales estudiadas permitieron demostrar la etiología del brote al permitir el aislamiento del hongo (10,11).…”

Section: Discussionunclassified

“…En nuestro medio se ha informado el aislamiento del hongo en tierras de cuevas cercanas a poblaciones donde se diagnosticaron casos de histoplasmosis aguda relacionada con visitas a estos sitios (9)(10)(11)(12). Además, ya se ha mencionado el riesgo que representan las tierras contaminadas con microorganismos patógenos para el hombre, las que al ser disturbadas y aerosolizadas, se convierten en contaminantes del aire (13,14).…”

Section: Discussionunclassified

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Brote de histoplasmosis aguda en un grupo familiar: identificación de la fuente de infección

Jiménez¹,

Urán²,

Bedout³

et al. 2002

biomedica

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Se informa un brote de histoplasmosis ocurrido en los integrantes de una familia y que comprometió a cuatro personas, dos mujeres, una niña y un hombre. El caso índice consultó por sintomatología respiratoria grave, de comienzo súbito, que requirió hospitalización. En los otros casos, la infección cursó de manera asintomática pero se puso en evidencia por la reactividad en las pruebas serológicas con histoplasmina. La búsqueda de una fuente común de contagio llevó a sospechar que era la tierra de un vivero que se había utilizado como fertilizante de las plantas caseras. Las suspensiones de las tierras de las macetas sirvieron para inocular ratones BALB/c, de cuyos órganos fue posible aislar el agente etiológico, Histoplasma capsulatum var. capsulatum. Si bien la histoplasmosis es más frecuente en ciertas ocupaciones y es propia de áreas rurales, las epidemias y los brotes son ahora comunes en áreas urbanas debido a actividades como la urbanización masiva, la tala de árboles, las demoliciones y el uso de tierras enriquecidas con abonos orgánicos (gallinaza, guano). Se llama la atención sobre el peligro que representa esta última actividad.Palabras clave: histoplasmosis, epidemiología, etiología, aislamiento y purificación, exposición ambiental, exposición por inhalación, Acute histoplasmosis outbreak in a family group: identification of infection sourceAn outbreak of acute histoplasmosis occurring in 4 members of the same family, two women, a girl and a male, is reported. The index case presented acute respiratory symptoms, severe enough to require hospitalization. In the remaining persons, the infection was asymptomatic but was evidenced by reactive histoplasmin serologic tests. Search for the common source of infection led to an enriched soil obtained in a local nursery for growing in-door plants. BALB/c mice were inoculated with suspensions of soils from the potted plants. Histoplasma capsulatum var. capsulatum was isolated from various internal organs of the mice. Although histoplasmosis is observed more frequently in persons with occupations implying risk of exposure and is connected to rural areas, outbreaks and intra-family cases are now common in urban areas. This is due to massive urbanization, deforestation, demolitions and the use of soils enriched with organic compounds, mainly bird/bat excrements. This report calls the attention on the danger involved in using such enriched soils for plant nutrition.

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Histoplasmosis: Epidemiology in Latin America

Gómez

2011

Curr Fungal Infect Rep

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Brotes de histoplasmosis registrados en el área andina colombiana

Cited by 13 publications

References 14 publications

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

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

Brote de histoplasmosis aguda en un grupo familiar: identificación de la fuente de infección

Histoplasmosis: Epidemiology in Latin America

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