Progressive disseminated histoplasmosis in the HIV population in Europe in the HAART era. Case report and literature review

Martín-Iguacel, Raquel; Kurtzhals, Jørgen A. L.; Jouvion, Grégory; Nielsen, Susanne Dam; Llibre, JM

doi:10.1007/s15010-014-0611-7

Cited by 23 publications

(28 citation statements)

References 55 publications

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“…About 300 histoplasmosis cases were reported up to 2007, mostly due the increase of the HIV-infected population, as well as antiretroviral therapy [ 35 ]. Imported cases of African histoplasmosis have been diagnosed in Europe [ 73 ]. Due to inefficiency and inaccuracy of diagnosis of deep mycosis in these areas, those numbers are likely to be an underestimate.…”

Section: Resultsmentioning

confidence: 99%

Worldwide Phylogenetic Distributions and Population Dynamics of the Genus Histoplasma

et al. 2016

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BackgroundHistoplasma capsulatum comprises a worldwide complex of saprobiotic fungi mainly found in nitrogen/phosphate (often bird guano) enriched soils. The microconidia of Histoplasma species may be inhaled by mammalian hosts, and is followed by a rapid conversion to yeast that can persist in host tissues causing histoplasmosis, a deep pulmonary/systemic mycosis. Histoplasma capsulatum sensu lato is a complex of at least eight clades geographically distributed as follows: Australia, Netherlands, Eurasia, North American classes 1 and 2 (NAm 1 and NAm 2), Latin American groups A and B (LAm A and LAm B) and Africa. With the exception of the Eurasian cluster, those clades are considered phylogenetic species.Methodology/Principal FindingsIncreased Histoplasma sampling (n = 234) resulted in the revision of the phylogenetic distribution and population structure using 1,563 aligned nucleotides from four protein-coding regions. The LAm B clade appears to be divided into at least two highly supported clades, which are geographically restricted to either Colombia/Argentina or Brazil respectively. Moreover, a complex population genetic structure was identified within LAm A clade supporting multiple monophylogenetic species, which could be driven by rapid host or environmental adaptation (~0.5 MYA). We found two divergent clades, which include Latin American isolates (newly named as LAm A1 and LAm A2), harboring a cryptic cluster in association with bats.Conclusions/SignificanceAt least six new phylogenetic species are proposed in the Histoplasma species complex supported by different phylogenetic and population genetics methods, comprising LAm A1, LAm A2, LAm B1, LAm B2, RJ and BAC-1 phylogenetic species. The genetic isolation of Histoplasma could be a result of differential dispersion potential of naturally infected bats and other mammals. In addition, the present study guides isolate selection for future population genomics and genome wide association studies in this important pathogen complex.

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Section: Resultsmentioning

confidence: 99%

Worldwide Phylogenetic Distributions and Population Dynamics of the Genus Histoplasma

et al. 2016

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“…While granulomas were thought to be a form of host protection, recent evidence suggests that Mycobacterium tuberculosis -induced granulomas serve as a repository for pathogenic organisms [37]. Reactivation histoplasmosis is a recognized clinical entity particularly in individuals that have left endemic areas into regions that are not known to contain the fungus [38, 39]. Although studies in the 1950s indicated that healed granulomas only contained dead organisms, the efficacy of organism recovery is unknown [40].…”

Section: Innate Immune Responsementioning

confidence: 99%

“…CD4 + and CD8 + T cells influence reactivation; elimination of both 6 weeks after infection elevates fungal burden [47]. These studies mimic the human situation in which AIDS patients living in nonendemic areas exhibit reactivation disease concomitant with low CD4 + T-cell counts [38]. …”

Section: Adaptive Immune Responsementioning

confidence: 99%

Histoplasma Capsulatum , Lung Infection and Immunity

2015

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Histoplasma capsulatum, an environmental fungus, is the most common endemic pulmonary mycosis in the USA. Disease is most frequently observed in immunocompromised patients living in endemic areas. We present the mechanisms of fungal recognition, innate immune response and adaptive immune response that lead to protection or exacerbation of disease. Current understanding of these mechanisms is the result of a continuing dialogue between clinical observations and murine studies. Mice are a powerful model to study the immune response to H. capsulatum alone or in the presence of immunomodulatory drugs. Vigilance for histoplasmosis should be exercised with novel immunosuppressive agents that target the important immune pathways identified here.

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“…This creates a well-defined tolerance between the host and the fungi ( Cassone & Cauda 2012 ). Most others, however, are environmental fungi that can become opportunistic pathogens in immune compromised hosts, like C. neoformans ( Iannitti et al 2012) , Aspergillus fumigatus ( Behnsen et al 2008) , Blastomyces dermatitidis ( Nanjappa & Klein 2014) , Histoplasma capsulatum ( Martin-Iguacel et al 2014) and Coccidioides immitis ( Ampel 2005) . Infection by these microorganisms occurs when the host fails to control spores or conidia that have been inhaled into the lungs.…”

Section: Fungi and The Relation With The Hostmentioning

confidence: 99%

New insights on the development of fungal vaccines: from immunity to recent challenges

Medici

Poeta

2015

Mem. Inst. Oswaldo Cruz

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Fungal infections are emerging as a major problem in part due to high mortality associated with systemic infections, especially in the case of immunocompromised patients. With the development of new treatments for diseases such as cancer and the acquired immune deficiency syndrome pandemic, the number of immunosuppressed patients has increased and, as a consequence, also the number of invasive fungal infections has increased. Several studies have proposed new strategies for the development of effective fungal vaccines. In addition, better understanding of how the immune system works against fungal pathogens has improved the further development of these new vaccination strategies. As a result, some fungal vaccines have advanced through clinical trials. However, there are still many challenges that prevent the clinical development of fungal vaccines that can efficiently immunise subjects at risk of developing invasive fungal infections. In this review, we will discuss these new vaccination strategies and the challenges that they present. In the future with proper investments, fungal vaccines may soon become a reality.

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Progressive disseminated histoplasmosis in the HIV population in Europe in the HAART era. Case report and literature review

Abstract: European infectious diseases physicians, microbiologists and pathologists must be aware of histoplasmosis, particularly when facing HIV-infected immigrants from endemic areas. This is increasingly important due to migration and travel activities from these areas.

Cited by 23 publications

References 55 publications

Worldwide Phylogenetic Distributions and Population Dynamics of the Genus Histoplasma

Worldwide Phylogenetic Distributions and Population Dynamics of the Genus Histoplasma

Histoplasma Capsulatum , Lung Infection and Immunity

New insights on the development of fungal vaccines: from immunity to recent challenges

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