Diagnosis and management of Histoplasmosis

Lj, Wheat

doi:10.1007/bf01964063

Cited by 70 publications

(54 citation statements)

References 72 publications

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“…As culturas também raramente mostram positividade na forma aguda. Na histoplasmose pulmonar crônica, as culturas de escarro obtidas por coleta habitual ou por broncoscopia podem demonstrar crescimento do fungo, geralmente dentro de duas semanas 13 .…”

Section: Diagnósticounclassified

“…Biópsias de pele ou mucosas, pulmão, medula óssea, fígado, linfonodos e intestinos demonstram a presença de granulomas epitelióides, de aspecto sarcóide, onde os microrganismos podem ser vistos no interior das células fagocíticas; colorações especiais, tais como Gomori-Grocott e PAS, são necessárias para a visualização adequada do fungo 13 .…”

Section: Diagnósticounclassified

“…A prova de imunodifusão é mais específica, mas menos sensível do que a fixação de complemento. Técnicas imunoenzimáticas (ELISA) também já se encontram padronizadas para o diagnóstico da histoplasmose e a experiência clínica até então acumulada demonstra serem estas provas mais sensíveis e específicas que a fixação de complemento 13 .…”

Section: Diagnósticounclassified

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Histoplasmose

Ferreira

Borges

2009

Rev. Soc. Bras. Med. Trop.

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RESUMOA histoplasmose é uma micose causada por fungo dimórfico, o Histoplasma capsulatum. É considerada classicamente uma micose endêmica, embora o fungo tenha um comportamento oportunístico em pacientes com depressão da imunidade celular. O homem adquire a infecção através da inalação de conídeos presentes na natureza (cavernas com morcegos, galinheiros, etc). O quadro clínico pode variar, desde infecções assintomáticas até quadros graves disseminados, que acometem pacientes com Aids, transplantados ou com neoplasias hematológicas. O diagnóstico baseia-se no encontro do fungo em fluidos orgânicos (escarro, sangue, líquor) ou tecidos (histopatologia), na cultura de materiais biológicos e na sorologia. O tratamento das formas agudas graves, respiratória crônica ou de formas localizadas pode ser feito com azólicos orais (itraconazol) e nas disseminadas, a Anfotericina B (preferencialmente as formulações lipídicas) constitui a droga da eleição para iniciar a terapia. A histoplasmose representa, hoje uma das micoses sistêmicas mais importantes nas Américas, com ampla distribuição em todas as regiões do Brasil. Palavras-chaves:Histoplasmose. Histoplasma capsulatum. Micose sistêmica. Síndrome da imunodeficiência adquirida. ABSTRACTHistoplasmosis is a fungal infection caused by the dimorphic fungus Histoplasma capsulatum. It is classically considered an endemic mycosis, even though the fungus has an opportunistic behavior in immunocompromised patients. People acquired the infection through the inhalation of conidial forms present in the environmental, such as caves dwelling bats and soils inhabited by chickens. The clinical features may vary from asymptomatic infections to disseminated severe forms that affect patients with acquired immunodeficiency syndrome or hematological malignancies and allograft recipients. The diagnosis is based on the detection of the fungus in organic fluids (sputum, blood, liquor) or tissues (histopathological assays), in the culture of biological samples and serological assays. The treatment of severe chronic respiratory acute or localized forms can be performed with oral azolic (itraconazol) and in the disseminated forms, the amphotericin B (preferentially the lipidic formulations) consists in the elected drug to initiate the therapy. Nowadays, histoplasmosis represents one of the most important systemic mycosis in the Americas, with broad distribution in all regions of Brazil. Key-words: Histoplasmosis. Histoplasma capsulatum. Systemic mycosis. Acquired immunodeficiency syndrome.A histoplasmose é uma micose sistêmica causada por um fungo dimórfico, o Histoplasma capsulatum. A doença foi pela primeira vez descrita por Samuel Darling, no Panamá, que entre 1905 e 1906 necropsiou três casos disseminados da doença, dois dos quais provenientes da Ilha de Martinica, onde hoje esta micose é reconhecidamente endêmica. A doença descrita por este patologista era similar à leishmaniose visceral e, portanto, foi por ele considerada erroneamente ser causada por um protozoário encapsulado. Somente em 193...

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Section: Diagnósticounclassified

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Histoplasmose

Ferreira

Borges

2009

Rev. Soc. Bras. Med. Trop.

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“…Histopathologic diagnosis is advantageous because it is more rapid than culture. Pathogenic fungi may require 2 to 3 weeks or longer to grow (39,40). A positive culture may also represent colonization rather than true invasion, especially when opportunistic organisms are isolated (7,16).…”

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Rapid Identification of Dimorphic and Yeast-Like Fungal Pathogens Using Specific DNA Probes

et al. 2001

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Specific oligonucleotide probes were developed to identify medically important fungi that display yeast-like morphology in vivo. Universal fungal primers ITS1 and ITS4, directed to the conserved regions of ribosomal DNA, were used to amplify DNA from Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioides immitis, Paracoccidioides brasiliensis, Penicillium marneffei, Sporothrix schenckii, Cryptococcus neoformans, five Candida species, and Pneumocystis carinii. Specific oligonucleotide probes to identify these fungi, as well as a probe to detect all dimorphic, systemic pathogens, were developed. PCR amplicons were detected colorimetrically in an enzyme immunoassay format. The dimorphic probe hybridized with DNA from H. capsulatum, B. dermatitidis, C. immitis, P. brasiliensis, and P. marneffei but not with DNA from nondimorphic fungi. Specific probes for H. capsulatum, B. dermatitidis, C. immitis, P. brasiliensis, P. marneffei, S. schenckii, C. neoformans, and P. carinii hybridized with homologous but not heterologous DNA. Minor cross-reactivity was observed for the B. dermititidis probe used against C. immitis DNA and for the H. capsulatum probe used against Candida albicans DNA. However, the C. immitis probe did not cross-react with B. dermititidis DNA, nor did the dimorphic probe hybridize with C. albicans DNA. Therefore, these fungi could be differentiated by a process of elimination. In conclusion, probes developed to yeast-like pathogens were found to be highly specific and should prove to be useful in differentiating these organisms in the clinical setting.

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“…During the 1980s and 1990s, the increase in the population of immunocompromised or human immunodeficiency virus infections was marked. The increased use of immunosuppressive agents in association with organ transplants, chemotherapy, and improved life-saving medical techniques necessitating indwelling catheters led to a substantial increase in the occurrence of serious fungal infections [2][3][4][5][6][7]. The major contribution to the increase of systemic fungal infections is due to candidiasis and aspergillosis [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

QSAR studies of a number of triazole antifungal alcohols

Nowaczyk

Modzelewska-Banachiewicz

2010

Open Chemistry

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Abstract:The activity of fungicide agents containing a quinazolinone ring was described using the quantitative structure-activity relationship (QSAR) model by applying it to data taken from literature. The title compounds exhibit two important types of activity against certain fungal pathogens, i.e. activity against yeast and activity against filamentous fungi. A correlation between both antifungal activities (e.g. FA(yst) and FA(ff)) and physicochemical parameters such as the logarithm of the n-octanol/water partition coefficient (log P), the polarizability (P), the global minimum energy (TE), the energy difference between the frontier molecular orbital (DELH) and the molar refractivity (MR), was established using multiple linear regression. The molecular descriptors of the antifungal agents were obtained by quantum chemical calculations combined with molecular modeling calculations. Statistical analysis shows that the antifungal activity depends mainly on the calculated partition coefficients, log P, of the compounds. Bi-parametric models reveal that antifungal activity relates linearly to log P and P. © Versita Sp. z o.o.

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Diagnosis and management of Histoplasmosis

Cited by 70 publications

References 72 publications

Histoplasmose

Histoplasmose

Rapid Identification of Dimorphic and Yeast-Like Fungal Pathogens Using Specific DNA Probes

QSAR studies of a number of triazole antifungal alcohols

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