Pulmonary co-infection with Pneumocystis jirovecii and Histoplasma capsulatum in AIDS patients is not a rare event

Abstract

Pulmonary co-infection with Pneumocystis jirovecii and Histoplasma capsulatum in AIDS patients is not a rare event We read with interest the article by Carreto-Binaghi et al. (2019) on Histoplasma capsulatum and Pneumocystis jirovecii co-infection published in the International Journal of Infectious Diseases. The authors performed the detection of the two fungi using PCR assays in bronchoalveolar lavage (BAL) specimens from patients monitored in their centre in Mexico City. Among the 289 patients screened, 84 were HIV-infected and 32 (38.1%), 16 (19%), and 9 (10.7%) were infected with P. jirovecii, H. capsulatum, and both fungi, respectively. Positive results of H. capsulatum culture were obtained in only four out of the 16 patients mentioned above. In 2013, we published a photo-quiz showing an alveolar macrophage containing a cluster of P. jirovecii trophic forms and one spore of H. capsulatum (Le Gal et al., 2013). The diagnosis was performed by examining a BAL specimen from an HIV-positive patient from Martinique (West French Indies), who had been living in metropolitan France for 1 year. This overseas French territory is an area where histoplasmosis is endemic, and Pneumocystis pneumonia (PCP) and disseminated histoplasmosis represent frequent AIDS-defining illnesses (Le Gal et al., 2013). We were

When dyspnea is a Hickam’s Dictum

“…Concurrent infection with Pneumocystis jirovecii , Histoplasma capsulatum and Mycobacterium avium complex is a very rare entity among patients living with HIV in the era of highly effective antiretrovirals [1] . This case highlights the occurrence of these synchronous infections in individuals with Acquired Immune Deficiency Syndrome (AIDS).…”