Histoplasmosis in Renal Transplant Patients in an Endemic Area at a Reference Hospital in Medellin, Colombia

Nieto­-Ríos, John Fredy; Higuita, Lina María Serna; Guzmán-Luna, Carlos Ernesto; Ocampo-­Kohn, Catalina; Aristizábal­-Alzate, Arbey; Ramírez, Isabel; Vélez-Echeverri, Catalina; Vanegas-Ruiz, Juan José; Zuleta, John Jairo; Zuluaga-Valencia, G.A.

doi:10.1016/j.transproceed.2014.06.060

Cited by 27 publications

(50 citation statements)

References 26 publications

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“…1,2,5 Furthermore, a latent focus has been found in the host that can be reactivated at the onset of risk factors that reduce the immune response, such as transplants, hematologic malignancies, therapy with corticosteroids, or the advanced stages of human immunodeficiency virus/acquired immunodeficiency syndrome. 1,6,7 Since the first isolation by Emmons, [8][9][10] numerous studies have confirmed the presence of H. capsulatum in soils rich in nitrogen and phosphorus, such as soils containing bird and bat excrement. [10][11][12][13][14] In 1968, Lockwood and Garrison 15 demonstrated the ability of H. capsulatum to grow with different concentrations of nitrogen (N), which was shown to promote fungal growth.…”

Section: Introductionmentioning

confidence: 99%

Detection of Histoplasma capsulatum in Organic Fertilizers by Hc100 Nested Polymerase Chain Reaction and Its Correlation with the Physicochemical and Microbiological Characteristics of the Samples

Gómez

Torres

Jiménez-A

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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is the causative agent of histoplasmosis and this fungus inhabits soils rich in phosphorus and nitrogen that are enriched with bird and bat manure. The replacement of organic matter in agroecosystems is necessary in the tropics, and the use of organic fertilizers has increased. Cases and outbreaks due to the presence of the fungus in these components have been reported. The Instituto Colombiano Agropecuario resolution 150 of 2003 contains the parameters set by the Colombian Technical Standard (NTC 5167) on the physicochemical and microbiological features of fertilizers, but it does not regulate the search for . The aim of this study was to demonstrate presence in organic fertilizers by nested polymerase chain reaction (PCR). A total of 239 samples were collected: 201 (84.1%) corresponded to organic fertilizers, 30 (12.5%) to bird excrement, and 8 (3.4%) to cave soils. The Hc100 nested PCR had a detection limit of 0.1 pg/µL and a specificity of 100%. A total of 25 (10.5%) samples were positive and validated by sequencing. Seven of the positive samples represented locations where was previously detected, suggesting the persistence of the fungus. No significant correlations were detected between the physicochemical and microbiological parameters with the presence of by nested PCR, indicating the fungus existence in organic fertilizers that complied with the NTC 5167. The Hc100 nested PCR targeting standardized in this work will improve the evaluation of organic fertilizers and ensure the prevention of outbreaks and cases due to manufacturing, marketing, and use of fertilizers contaminated with.

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Section: Introductionmentioning

confidence: 99%

Detection of Histoplasma capsulatum in Organic Fertilizers by Hc100 Nested Polymerase Chain Reaction and Its Correlation with the Physicochemical and Microbiological Characteristics of the Samples

Gómez

Torres

Jiménez-A

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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“…Although the 1‐year cumulative incidence of endemic fungal infections was only 0.2%, they were more common than either zygomycosis or Pneumocystis jirovecii pneumonia. Even in endemic areas with positive skin histoplasmin reactivity >50%, PTH is rare, with a reported incidence of ≤1% . The true incidence, however, is likely to be higher due to underreporting, misdiagnosis and, especially in earlier studies, lack of availability or use of histoplasma antigen assays.…”

Section: Solid Organ Transplant Recipientsmentioning

confidence: 99%

“…Acute cellular rejection with resultant escalation of immunosuppressive therapy has been variably associated with PTH . In a large multicenter study, only 10% patients had rejection episodes within 3 months before diagnosis, while in another study from South America 88% had rejection episodes prior to the diagnosis of PTH . Cytomegalovirus (CMV) is known to increase the net state of immunosuppression and increase the risk of some opportunistic infections but its effect on PTH has not been established even though coinfection has been occasionally described …”

Section: Solid Organ Transplant Recipientsmentioning

confidence: 99%

Histoplasmosis in transplant recipients

Gajurel

Dhakal

Deresinski

2017

Clinical Transplantation

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Histoplasma capsulatum is a dimorphic fungus that most often causes asymptomatic infection in the immunocompetent population. In immunocompromised patients, including solid organ transplant (SOT) and hematopoietic cell transplant (HCT) recipients, however, it is likely to cause severe life-threatening infection. Post-transplant histoplasmosis (PTH) in SOT is uncommon with an incidence of ≤1% and is even rarer in HCT patients. The majority of PTH in SOT is diagnosed in the first 2 years following transplantation. Histoplasmosis may result from endogenous reactivation of latent infection, de novo post-transplant acquisition, and donor-derived infection. Disseminated infection is common. Fever is the most common symptom and clinical features are often nonspecific, but patients with disseminated infection may present with a septic picture. Other features, including pancytopenia and hepatosplenomegaly, may not be prominent early in the course of illness. Contemporary histoplasma antigen assays are the most sensitive tests but cross-reactivity with antigens of other fungi, including with Aspergillus galactomannan, is not uncommon. Treatment should be continued for at least a year. Histoplasma antigen levels have prognostic value and can be used to monitor the response to therapy. The attributable mortality is approximately 10%. Routine screening of donors and recipients is not currently recommended.

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“…In addition to the cited cohort studies, several additional case reports of IFIs in adults under anti‐CD52 treatment are reported, including (i) aspergillosis, (ii) cryptococcosis, (iii) PJP, (iv) mucormycosis, (v) blastomycosis, (vi) histoplasmosis, (vii) fusariosis and (viii) microsporidiosis . A case of “fungal oesophagitis” due to alemtuzumab was also identified …”

Section: Induction Of Lymphopeniamentioning

confidence: 99%

Invasive fungal infections in paediatric patients treated with macromolecular immunomodulators other than tumour necrosis alpha inhibitors

Kyriakidis

Tragiannidis

Zündorf

et al. 2017

Mycoses

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An expanding list of immunomodulatory or immunosuppressive monoclonal antibodies (mAbs) and biologic therapeutics is currently entering clinical practice, particularly in the areas of oncology, transplantation and autoimmune disorders. These agents are directed against molecules or cells involved in inflammation and immunity and may therefore be associated with serious and opportunistic infections. The purpose of this review was to critically analyse the literature on invasive fungal infections (IFIs) occurring in association with mAbs and fusion proteins other than tumour necrosis alpha (TNF-α) inhibitors, including therapeutics modulating T-cell-mediated pathologies (muromonab, abatacept, belatacept, ipilimumab, basiliximab, daclizumab), inducing lymphopenia (alemtuzumab), depleting CD20+ B cells (rituximab) and interfering with various targets (anakinra, natalizumab, blodalumab, ixekizumab and others) with a focus on children, and to provide a framework of evaluating the risk for IFIs in this population.

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Histoplasmosis in Renal Transplant Patients in an Endemic Area at a Reference Hospital in Medellin, Colombia

Cited by 27 publications

References 26 publications

Detection of Histoplasma capsulatum in Organic Fertilizers by Hc100 Nested Polymerase Chain Reaction and Its Correlation with the Physicochemical and Microbiological Characteristics of the Samples

Detection of Histoplasma capsulatum in Organic Fertilizers by Hc100 Nested Polymerase Chain Reaction and Its Correlation with the Physicochemical and Microbiological Characteristics of the Samples

Histoplasmosis in transplant recipients

Invasive fungal infections in paediatric patients treated with macromolecular immunomodulators other than tumour necrosis alpha inhibitors

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