Outbreak of histoplasmosis associated with the 1970 earth day activities

Brodsky, Alan L.; Gregg, Michael B.; Loewenstein, Matthew S.; Kaufman, Leo; Mallison, George F.

doi:10.1016/0002-9343(73)90028-4

Cited by 65 publications

(32 citation statements)

References 3 publications

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“…Exposure in enclosed areas, such as buildings or caves usually causes more severe illnesses than exposure occurring outdoors (16)(17)(18). Also, attack rates are higher when exposure occurs in schools or other areas involving children, as children are less likely than adults to be immune as a result of previous infection (18)(19)(20)(21).…”

Section: Historymentioning

confidence: 99%

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Diagnosis and management of Histoplasmosis

1989

Eur. J. Clin. Microbiol. Infect. Dis.

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Histoplasmosis occurs throughout the world but is more common within the endemic areas of North America, particularly in fertile river valleys. Disease manifestations range from asymptomatic infection in the normal host with low-inoculum exposure to rapidly fatal, disseminated infection in the severely immunocompromised host, emphasizing the importance of cellular immunity in defense against Histoplasma capsulatum. Diagnosis depends on a high index of suspicion, knowledge of the clinical and epidemiologic features of the infection, and a thorough understanding of the uses and limitations of fungal cultural and serological laboratory procedures. Recently, a method has been developed for rapid diagnosis based on detection of a polysaccharide antigen in body fluids of patients with histoplasmosis. Amphotericin B remains the preferred treatment for more severe forms of histoplasmosis, particularly in the immunocompromised host, but oral treatment with ketoconazole or newer imidozoles appears to be effective in less severe infections in non-immunocompromised individuals.

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Section: Historymentioning

confidence: 99%

“…About 80 % present with flu-like, acute pulmonary symptoms of fever, chills, headache, thigh pain, myalgia, anorexia, non-productive cough, and retrosternal or pleuritic chest pain (60-80%) (16,18,38). Examination is usually normal but may reveal erythema nodosum or multiforme.…”

Section: Self-limited Histoplasmosis With Low-inoculummentioning

confidence: 99%

Diagnosis and management of Histoplasmosis

1989

Eur. J. Clin. Microbiol. Infect. Dis.

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“…Outbreaks that involve anywhere from a handful to tens of thousands of individuals have been described (8,131,136). Every year, hundreds of thousands of individuals in the United States and Central America are infected with H. capsulatum.…”

Section: Introductionmentioning

confidence: 99%

Histoplasmosis: a Clinical and Laboratory Update

2007

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SUMMARY Infection with Histoplasma capsulatum occurs commonly in areas in the Midwestern United States and Central America, but symptomatic disease requiring medical care is manifest in very few patients. The extent of disease depends on the number of conidia inhaled and the function of the host's cellular immune system. Pulmonary infection is the primary manifestation of histoplasmosis, varying from mild pneumonitis to severe acute respiratory distress syndrome. In those with emphysema, a chronic progressive form of histoplasmosis can ensue. Dissemination of H. capsulatum within macrophages is common and becomes symptomatic primarily in patients with defects in cellular immunity. The spectrum of disseminated infection includes acute, severe, life-threatening sepsis and chronic, slowly progressive infection. Diagnostic accuracy has improved greatly with the use of an assay for Histoplasma antigen in the urine; serology remains useful for certain forms of histoplasmosis, and culture is the ultimate confirming diagnostic test. Classically, histoplasmosis has been treated with long courses of amphotericin B. Today, amphotericin B is rarely used except for severe infection and then only for a few weeks, followed by azole therapy. Itraconazole is the azole of choice following initial amphotericin B treatment and for primary treatment of mild to moderate histoplasmosis.

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“…The vast majority of human infections are asymptomatic, but acute severe pulmonary infection occurs in either an immunosuppressed host or an immunocompetent host who inhales a large inoculum of H. capsulatum cells. Outbreaks of anywhere from a few to tens of thousands of people have occurred (Brodsky et al 1973;Wheat et al 1981;Wheat 1997). …”

Section: Histoplasma Capsulatummentioning

confidence: 99%