Disseminated histoplasmosis in Peruvian non-HIV patients: an underrecognized endemic disease

Chincha, Omayra; Bustamante, Beatriz

doi:10.1016/j.mycmed.2021.101177

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…This 14-year study identified 34 cases of histoplasmosis in non-HIV patients requiring hospitalization and treatment. This small sample is similar to that presented in studies carried out in neighboring countries in the same geographical area of the Amazon with an endemic presence of histoplasmosis, such as Brazil [2] and Peru [17]. On the other hand, although the exact incidence of mild or non-symptomatic histoplasmosis in endemic areas in French Guiana or in other neighboring countries of South America is unknown, histoplasmin skin test prevalence used in the early of 1950s allowed for the revelation of the extent of Histoplasma capsulatum infection in many areas [23].…”

Section: Discussionsupporting

confidence: 84%

“…The endogenous reactivation of previously inhaled spores that have remained quiescent yeasts in the host organism, similar to what is known for tuberculosis, has been suggested [ 7 , 8 , 9 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 24 , 25 , 26 , 27 ] and could explain certain forms of histoplasmosis occurring in immunocompetent patients several months after their return from a trip to an endemic area. However, in French Guiana, data from HIV cohorts have shown a substantial seasonal component, suggesting de novo infections [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have described histoplasmosis as the most frequent opportunistic infection in people living with the Human Immunodeficiency Virus (PLHIV) since the use of highly active antiretroviral therapy (HAART) [ 11 , 12 , 13 , 14 ]. In French Guiana, it is considered the first AIDS-defining condition, and it used to be the first cause of AIDS-related death [ 14 , 15 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Histoplasmosis in Non-HIV Infected Patients: Another Neglected Infection in French Guiana

Aissaoui,

Bourne-Watrin,

Lemarie

et al. 2024

JoF

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(1) Background: Only a few studies on histoplasmosis in immunocompetent patients have been reported in French Guiana. Therefore, we conducted a detailed clinical description of hospitalized patients suffering with histoplasmosis among non-HIV patients. (2) Methods: This is a single-center, retrospective study conducted at Cayenne Hospital Center between 2008 and 2022. (3) Results: Our cohort was composed of 31 (91%) adults (>18 years of age) and 3 (9%) children, with a sex ratio, M:F, of 1:2. The median age was higher among the women than among the men (70 versus 54 years). The collection of respiratory samples constituted the majority of the performed examinations (38%). Fever (>37 °C) was found in 56% of patients. Surprisingly, the histoplasmosis was disseminated in 82% of patients with an overall case fatality rate of 14.7%. However, immunosuppressive conditions were found in 52% (16/31) of the adult patients, including lymphoid hemopathies, diabetes and immunosuppressive drugs. Conclusions: This disease, though rare and usually considered a mostly benign disease in non-HIV patients, presented a relatively high mortality rate in our cohort. Thus, histoplasmosis should be suspected, screened and investigated as a first line of defense in highly endemic areas, even in immunocompetent and non-HIV patients, especially those with fever or chronic respiratory symptoms.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Histoplasmosis in Non-HIV Infected Patients: Another Neglected Infection in French Guiana

Aissaoui,

Bourne-Watrin,

Lemarie

et al. 2024

JoF

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Histoplasmosis oral en un paciente con enfermedad inflamatoria del intestino tratado con adalimumab

Rojas¹,

Galvis²,

Calfat³

et al. 2023

Piel

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Histoplasmosis in non-immunosuppressed patients from an endemic area in Northeastern Brazil

Leitão,

Rodrigues,

Farias

et al. 2024

Medical Mycology

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Differently from immunocompromised patients, very little information is available in the literature regarding the clinical presentation, epidemiology, and outcomes of histoplasmosis in non-immunosuppressed individuals living in endemic areas. This retrospective case series study was carried out by reviewing the medical records of non-immunocompromised patients with histoplasmosis, residents in a hyperendemic area in northeastern Brazil, between 2011 and 2022. Thirty HIV-negative patients were identified with histoplasmosis, and 19 cases met the inclusion criteria: ten patients had acute pulmonary histoplasmosis (APH), one had chronic pulmonary histoplasmosis (CPH), two had progressive disseminated (PD) presentation, and six had the chronic disseminated (CD) form. The median age of our sample was 32.7 years old [IQR: 24 - 45]. Most of the patients were male (male-to-female ratio=15:4) and resided in the state capital (n=9). The majority had a previous history of exposure to well-known risk factors for Histoplasma infection. The lung images of APH were characterized by nodules, enlarged hilar/mediastinal lymph nodes, and patches, and three patients were initially treated empirically for pulmonary tuberculosis; one death was registered. The chronic pulmonary form of histoplasmosis was diagnosed in one patient only after the symptoms persisted despite specific treatment. The primary clinical manifestations of the CD form were enlarged lymph nodes, with histopathology being the main diagnostic method. The cases were detected as isolated occurrences and not as an outbreak, suggesting that exposure to Histoplasma can be more widespread than presumed. Despite the self-limiting nature of the disease, death can occur even in previously heath patients.

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Disseminated histoplasmosis in Peruvian non-HIV patients: an underrecognized endemic disease

Cited by 3 publications

References 14 publications

Histoplasmosis in Non-HIV Infected Patients: Another Neglected Infection in French Guiana

Histoplasmosis in Non-HIV Infected Patients: Another Neglected Infection in French Guiana

Histoplasmosis oral en un paciente con enfermedad inflamatoria del intestino tratado con adalimumab

Histoplasmosis in non-immunosuppressed patients from an endemic area in Northeastern Brazil

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