Histoplasmosis in Malaya

Ponnampalam, J. T.

doi:10.1016/s0007-0971(64)80032-2

Cited by 12 publications

(6 citation statements)

References 2 publications

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“…The first are the geographically restricted systemic mycoses. These include histoplasmosis (25–32), blastomycosis, and coccidiomycosis in North America (and parts of Latin America, Europe, and even Asia in the case of histoplasmosis); paracoccidioidomycosis in Central and South America; and penicilliosis (caused by Penicillium marneffei ) in Southeast Asia, including Vietnam, Thailand, and southern China. These infections share several characteristics in common (33–38): a pulmonary portal of entry; the possibility of systemic dissemination; impaired cell‐mediated immunity playing a major role in the susceptibility to these infections (hence the vulnerability of transplant recipients); and a variety of epidemiologic patterns of infection acquisition – primary infection , with the possibility of both progressive pulmonary disease and post‐primary dissemination; reactivation disease with or without secondary dissemination; and superinfection in the face of a large environmental exposure in the setting of attenuated immunity.…”

Section: Discussionmentioning

confidence: 99%

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A renal transplant recipient with pulmonary nodules

Tan¹,

Cheah

Chew

et al. 2005

Transplant Infectious Dis

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Section: Discussionmentioning

confidence: 99%

“…Therefore, close attention to blood levels of the calcineurin inhibitors is necessary, with the expectation that a >50% decrease in dose will be necessary. Conversely, when the azole is discontinued, increased doses of cyclosporine and tacrolimus will be necessary, again guided by blood levels (1–3, 25–32).…”

Section: Discussionmentioning

confidence: 99%

A renal transplant recipient with pulmonary nodules

Tan¹,

Cheah

Chew

et al. 2005

Transplant Infectious Dis

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“…It seems possible that this patient acquired the primary infection in Malaya during the war since the organism is known to occur there. Ponnampalam (1963) isolated H. capsulatum from the soil of a bat-infested cave in central Malaya; he also investigated 227 adult patients admitted to hospital in Kuala Lumpar with respiratory symptoms and found 10-5 % had a positive histoplasmin skin test and 19-8 % had a positive histoplasma complementfixation test (Ponnampalam, 1964). If infection did occur in Malaya, it was 25-30 years before the disease became manifest, but in two of the cases of disseminated histoplasmosis described by Macleod et al (1972) the patients had lived in England for 16 and 18 years since travelling abroad.…”

Section: Discussionmentioning

confidence: 99%

Disseminated histoplasmosis successfully treated with amphotericin B

et al. 1974

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SYNOPSIS A 61-year-old woman presented with malaise, intermittent fever, weight loss, and epigastric pain. Histoplasma capsulatum was eventually isolated from a liver biopsy and from the bone marrow and the patient was successfully treated with amphotericin B.Disseminated histoplasmosis is very rarely seen in Great Britain; there have been only 11 reported cases, with positive cultures in eight (Macleod, Murray, Davidson, and Gibbs, 1972 six-month history of malaise, weight loss, and intermittent fever. She also complained of epigastric pain and flatulence. The only abnormal physical findings were a persistent lowgrade pyrexia and an enlarged, tender liver. The only abnormalities revealed on initial investigation were an ESR (Westergren) of 15 to 29 mm/hr, a serum amino-aspartate transferase of 85 iu/l (normal range 25-65 iu/l), and an alkaline phosphatase of 20 KA units/100 ml (normal range 4-13 KA units/ 100 ml). Chest radiography and white count were normal. A liver biopsy was performed on 29 June, and histology showed non-caseating giant cell granulomata but no acid-fast bacilli nor fungi were seen. The biopsy material was not cultured. Tuberculosis was strongly suspected and therapy was begun with isoniazid, para-aminosalicylic acid, and streptomycin. After three weeks these drugs were stopped as the fever continued unabated and her symptoms remained unaltered. A further liver biopsy showed unchanged histology. The specimen was

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“…Historically Hcc epidemiology has been neglected in South East Asia despite a review in 1970 by H. S. Randhawa that found a total of 30 autochthonous cases, half being culture confirmed, in Malaysia, Indonesia, Singapore, Thailand, South Vietnam, India and Japan [25]. Hcc was found in bat guano in Malaysia and prior exposure was common as measured by skin sensitivity [26]. The one regional exception is Thailand; its Ministry of Public Health reported 1253 disseminated histoplasmosis cases among HIV infected patients from September 1984 to March 2010 [27].…”

Section: Introductionmentioning

confidence: 99%

Mapping histoplasmosis in South East Asia – implications for diagnosis in AIDS

Baker

Setianingrum

Wahyuningsih

et al. 2019

Emerging Microbes & Infections

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Histoplasmosis caused by the fungus Histoplasma capsulatum is often lethal in patients with AIDS. Urine antigen testing is highly sensitive and much quicker for diagnosis than culture. Histoplasmosis has a patchy and incompletely appreciated distribution around the world especially in South East Asia. We conducted a systematic literature review of cases of all disease forms of histoplasmosis in SE Asia, not including the Indian sub-continent. We also reviewed all histoplasmin skin test mapping studies to determine localities of exposure. We found a total of 407 cases contracted or likely to have been contracted in SE Asia. Numbers of cases by country varied: Thailand (233), Malaysia (76), Indonesia (48) and Singapore (21), with few or no cases reported in other countries. Most cases (255 (63%)) were disseminated histoplasmosis and 177 (43%) cases were HIV associated. Areas of high histoplasmin skin test sensitivity prevalence were found in Myanmar, the Philippines, Indonesia, Thailand and Vietnam - 86.4%, 26.0%, 63.6%, 36.0% and 33.7%, respectively. We have drawn maps of these data. Further study is required to ascertain the extent of histoplasmosis within SE Asia. Diagnostic capability for patients with HIV infection is urgently required in SE Asia, to reduce mortality and mis-diagnosis as tuberculosis.

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Histoplasmosis in Malaya

Cited by 12 publications

References 2 publications

A renal transplant recipient with pulmonary nodules

A renal transplant recipient with pulmonary nodules

Disseminated histoplasmosis successfully treated with amphotericin B

Mapping histoplasmosis in South East Asia – implications for diagnosis in AIDS

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