Histoplasmose

Ferreira, Marcelo Simão; Borges, Aércio Sebastião

doi:10.1590/s0037-86822009000200020

Cited by 66 publications

(100 citation statements)

References 17 publications

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“…A significant difference, p=0.01, was found between AIDS and non-AIDS patients, a difference already noticed in other reports and considered to be connected to the seriousness of the disease course in HIV patients (2,4,5,31,(37)(38)(39). The advanced stage of the latter infection in this series explains the clinical behavior of the mycosis, as observed by the lesser age found in this group as compared with those in the other risk factor groups; it may also explain, partially at least, the observed sex differences although here a more intense environmental exposure is also attributed to males.…”

Section: Diagnostic Methodssupporting

confidence: 55%

“…Besides presenting a more rapid course, the clinical course of the AIDS patients was also more aggressive and exhibited peculiar characteristics rarely informed in other patients groups, such as indicated by hematologic abnormalities and frequency and severity of skin lesions, as described earlier (2,4,5,31,(37)(38)(39). It should be noticed that skin lesions are seldom observed in North American patients (8,9).…”

Section: Diagnostic Methodsmentioning

confidence: 70%

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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: 55%

Section: Diagnostic Methodsmentioning

confidence: 70%

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

et al. 2011

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“…The clinical features may vary from asymptomatic infection to disseminated severe forms; the outcome of the infection with H. capsulatum is dependent on dynamic interactions between innate immunity, adaptive immunity and fungal virulence factors. 86 Skin and mucosal manifestations of histoplasmosis may occur, especially in the disseminated form (more frequent in the setting of immune suppression), as a result of hematogenic dissemination, together with lymph node involvement.…”

Section: Histoplasmosismentioning

confidence: 99%

Genetic risk factors for human susceptibility to infections of relevance in dermatology

Sardinha

Tarlé

Fava

et al. 2011

An. Bras. Dermatol.

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BACKGROUND: In the pre-microbiological era, it was widely accepted that diseases, today known to be infectious, were hereditary. With the discovery of microorganisms and their role in the pathogenesis of several diseases, it was suggested that exposure to the pathogen was enough to explain infection. Nowadays, it is clear that infection is the result of a complex interplay between pathogen and host, therefore dependant on the genetic make-up of the two organisms. Dermatology offers several examples of infectious diseases in different stages of understanding of their molecular basis. In this review, we summarize the main advances towards dissecting the genetic component controlling human susceptibility to infectious diseases of interest in dermatology. Widely investigated diseases such as leprosy and leishmaniasis are discussed from the genetic perspective of both host and pathogen. Others, such as rare mycobacterioses, fungal infections and syphilis, are presented as good opportunities for research in the field of genetics of infection. Keywords: Dermatology; Infection; Polymorphism, genetic Resumo: INTRODUÇÃO: Durante a era pré-microbiológica, era comum a visão de que doenças, hoje sabidamente infecciosas, eram hereditárias. Com a descoberta dos microorganismos e seu papel na patogênese de diversas patologias, chegou-se a propor que a exposição ao patógeno era condição suficiente para explicar infecção. Hoje, está claro que infecção é o resultado de uma complexa interação entre patógeno e hospedeiro, dependendo portanto, em última análise, do make-up genético de ambos os organismos. A dermatologia oferece diversos exemplos de doenças infecciosas em diferentes graus de entendimento de suas bases moleculares. Nesta revisão, resumimos os principais avanços na direção da dissecção do componente genético controlando suscetibilidade do ser humano a doenças infecciosas de importância na dermatologia. Doenças amplamente estudadas, como a hanseníase e a leishmaniose, são discutidas sob o ponto de vista da genética tanto do hospedeiro quanto do patógeno. Outras, como micobacterioses raras, micoses e sífilis, são apresentadas como boas oportunidades para pesquisa na área de genética de infecção.

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“…Prior to the AIDS epidemic, histoplasmosis was most frequently reported in outbreak events 20,23 , and the disseminated form was found primarily in patients with lymphoma or other cancers and sporadically in renal transplant patients 13 . However, since the 1980s, the disseminated form has been observed mainly in HIV-infected patients with advanced immunosuppression 13,16 .…”

Section: Introductionmentioning

confidence: 99%

“…However, since the 1980s, the disseminated form has been observed mainly in HIV-infected patients with advanced immunosuppression 13,16 . Several Brazilian states have reported cases of histoplasmosis associated with HIV infection 2,26 , however, the state of Ceará in Northeastern Brazil has had the highest incidence of AIDS/ histoplasmosis association in recent years 7,24 and one of the highest in the world 6 .…”

Section: Introductionmentioning

confidence: 99%

Histoplasmin Survey in Hiv-Positive Patients: Results From an Endemic Area in Northeastern Brazil

Bezerra

Zancopé‐Oliveira

Brilhante

et al. 2013

Rev. Inst. Med. trop. S. Paulo

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SUMMARYBackground. Disseminated histoplasmosis is common in AIDS patients with advanced immunosuppression in Ceará, Northeastern Brazil. The goal of this study was to determine the prevalence of Histoplasma infection in patients with HIV/AIDS living in Fortaleza, the capital of Ceará. Methods. Intradermal tests with histoplasmin (mycelial phase) were performed in 161 HIV patients with CD4 ≥ 350 cells/mm 3 . Evidence of recent illness was evaluated with immunodiffusion (ID) tests in 76 of these individuals. Results. A total of 11.8% of patients reacted to histoplasmin and 2.63% had ID test positive to Histoplasma. The presence of mango trees (Mangifera indica) in the patient neighborhood (OR = 2.870; 95% CI = 1.081-7.617; p = 0.040) and past activity involving soil (OR = 2.834; 95% CI = 1.045-7.687; p = 0.045) or visits to a farm (OR = 3.869; 95% CI = 1.189-12.591; p = 0.033) were significantly associated with Histoplasma infection. Conclusions. Patients with HIV living in Fortaleza have an expressive prevalence of infection with Histoplasma.

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Histoplasmose

Cited by 66 publications

References 17 publications

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

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

Genetic risk factors for human susceptibility to infections of relevance in dermatology

Histoplasmin Survey in Hiv-Positive Patients: Results From an Endemic Area in Northeastern Brazil

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