scholarly journals Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

2021 ◽  
Vol 7 (6) ◽  
pp. 481
Author(s):  
Spinello Antinori ◽  
Andrea Giacomelli ◽  
Mario Corbellino ◽  
Alessandro Torre ◽  
Marco Schiuma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Infection ◽  
Histoplasma Capsulatum ◽  
People Living With Hiv ◽  
Immunocompromised Patients ◽  
Dimorphic Fungus ◽  
Endemic Region ◽  
Disseminated Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis ◽  
Living With Hiv

Human histoplasmosis is a mycosis caused by two distinct varieties of a dimorphic fungus: Histoplasma capsulatum var. capsulatum and H. capsulatum var. duboisii. In Europe, it is usually imported by migrants and travellers, although there have been some autochthonous cases, especially in Italy; however, most European physicians are unfamiliar with its clinical and pathological picture, particularly among immunocompromised patients without HIV infection. This systematic review of all the cases of histoplasmosis reported in Europe and Israel between 2005 and 2020 identified 728 cases diagnosed in 17 European countries and Israel described in 133 articles. The vast majority were imported (mainly from Central and South America), but there were also seven autochthonous cases (six in Europe and one in Israel). The patients were prevalently males (60.4%), and their ages ranged from 2 to 86 years. The time between leaving an endemic region and the diagnosis of histoplasmosis varied from a few weeks to more than 40 years. Progressive disseminated histoplasmosis was the most frequent clinical picture among people living with HIV infection (89.5%) or a different immunocompromising condition (57.1%), but it was also recorded in 6.2% of immunocompetent patients. Twenty-eight cases were caused by Histoplasma duboisii. Immunocompromised patients without HIV infection had the worst outcomes, with a mortality rate of 32%.

scholarly journals Multicenter Validation of Commercial Antigenuria Reagents To Diagnose Progressive Disseminated Histoplasmosis in People Living with HIV/AIDS in Two Latin American Countries

2018 ◽  
Vol 56 (6) ◽  
Author(s):  
Diego H. Cáceres ◽  
Blanca E. Samayoa ◽  
Narda G. Medina ◽  
Angela M. Tobón ◽  
Brenda J. Guzmán ◽  
...  
Keyword(s):  
Latin American ◽  
Histoplasma Capsulatum ◽  
Enzyme Linked Immunosorbent Assay ◽  
People Living With Hiv ◽  
Content Type ◽  
Disseminated Histoplasmosis ◽  
Wide Range ◽  
Progressive Disseminated Histoplasmosis ◽  
Living With Hiv ◽  
Hiv Aids

ABSTRACTHistoplasmosis is an important cause of mortality in patients with AIDS, especially in countries with limited access to antiretroviral therapies and diagnostic tests. However, many disseminated infections in Latin America go undiagnosed. A simple, rapid method to detectHistoplasma capsulatuminfection in regions where histoplasmosis is endemic would dramatically decrease the time to diagnosis and treatment, reducing morbidity and mortality. The aim of this study was to validate a commercial monoclonalHistoplasmagalactomannan (HGM) enzyme-linked immunosorbent assay (Immuno-Mycologics [IMMY], Norman, OK, USA) in two cohorts of people living with HIV/AIDS (PLHIV). We analyzed urine samples from 589 people (466 from Guatemala and 123 from Colombia), including 546 from PLHIV and 43 from non-PLHIV controls. Sixty-three of these people (35 from Guatemala and 28 from Colombia) had confirmed histoplasmosis by isolation ofH. capsulatum. Using the standard curve provided by the quantitative commercial test, the sensitivity was 98% (95% confidence interval [CI], 95 to 100%) and the specificity was 97% (95% CI, 96 to 99%) (cutoff = 0.5 ng/ml). Semiquantitative results, using a calibrator of 12.5 ng/ml ofHistoplasmagalactomannan to calculate an enzyme immunoassay index value (EIV) for the samples, showed a sensitivity of 95% (95% CI, 89 to 100%) and a specificity of 98% (95% CI, 96 to 99%) (cutoff ≥ 2.6 EIV). This relatively simple-to-perform commercial antigenuria test showed a high performance with reproducible results in both countries, suggesting that it can be used to detect progressive disseminated histoplasmosis in PLHIV in a wide range of clinical laboratories in countries where histoplasmosis is endemic.

scholarly journals Typical Facial Lesions: A Window of Suspicion for Progressive Disseminated Histoplasmosis—A Case of Asian Prototype

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Prasan K. Panda ◽  
Siddharth Jain ◽  
Rita Sood ◽  
Rajni Yadav ◽  
Naval K. Vikram
Keyword(s):  
Histoplasma Capsulatum ◽  
Bone Marrow Aspiration ◽  
Febrile Illness ◽  
Immunocompetent Patient ◽  
Dimorphic Fungus ◽  
Recent Onset ◽  
Disseminated Histoplasmosis ◽  
The Face ◽  
History Of ◽  
Progressive Disseminated Histoplasmosis

Histoplasmosis is caused by a dimorphic fungusHistoplasma capsulatumin endemic areas, mainly America, Africa, and Asia. In India, it is being reported from most states; however, it is endemic along the Ganges belt. We report a case of an apparently immunocompetent male who presented with 3-month history of fever, cough, and weight loss with recent onset odynophagia and had hepatosplenomegaly and mucocutaneous lesions over the face. The differential diagnosis of leishmaniasis, tuberculosis, leprosy, fungal infection, lymphoproliferative malignancy, and other granulomatous disorders was considered, but he succumbed to his illness. Antemortem skin biopsy and bone marrow aspiration along with postmortem liver, lung, and spleen biopsy showed disseminated histoplasmosis. This case highlights the need for an early suspicion of progressive disseminated histoplasmosis in the presence of classical mucocutaneous lesions even in an immunocompetent patient suffering from a febrile illness. Cure rate approaches almost 100% with early treatment, whereas it is universally fatal if left untreated.

scholarly journals Diagnostic accuracy of antigen detection in urine and molecular assays testing in different clinical samples for the diagnosis of progressive disseminated histoplasmosis in patients living with HIV/AIDS: A prospective multicenter study in Mexico

2021 ◽  
Vol 15 (3) ◽  
pp. e0009215
Author(s):  
Areli Martínez-Gamboa ◽  
María Dolores Niembro-Ortega ◽  
Pedro Torres-González ◽  
Janeth Santiago-Cruz ◽  
Nancy Guadalupe Velázquez-Zavala ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Diagnostic Accuracy ◽  
Nested Pcr ◽  
Urine Samples ◽  
People Living With Hiv ◽  
Bone Marrow Tissue ◽  
Disseminated Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis ◽  
Sensitivity Specificity ◽  
Living With Hiv

Background The progressive disseminated histoplasmosis (PDH) has been associated with severe disease and high risk of death among people living with HIV (PLWHIV). Therefore, the purpose of this multicenter, prospective, double-blinded study done in ten Mexican hospitals was to determine the diagnostic accuracy of detecting Histoplasma capsulatum antigen in urine using the IMMY ALPHA Histoplasma EIA kit (IAHE), clarus Histoplasma GM Enzyme Immunoassay (cHGEI IMMY) and MiraVista Histoplasma Urine Antigen LFA (MVHUALFA); as well as the Hcp100 and 1281-1283220SCAR nested PCRs in blood, bone-marrow, tissue biopsies and urine. Methodology/Principal findings We included 415 PLWHIV older than 18 years of age with suspicion of PDH. Using as diagnostic standard recovery of H. capsulatum in blood, bone marrow or tissue cultures, or histopathological exam compatible, detected 108 patients (26%, [95%CI, 21.78–30.22]) with proven-PDH. We analyzed 391 urine samples by the IAHE, cHGEI IMMY and MVHUALFA; the sensitivity/specificity values obtained were 67.3% (95% CI, 57.4–76.2) / 96.2% (95% CI, 93.2–98.0) for IAHE, 91.3% (95% CI, 84.2–96.0) / 90.9% (95% CI, 87.0–94.0) for cHGEI IMMY and 90.4% (95% CI, 83.0–95.3) / 92.3% (95% CI, 88.6–95.1) for MVHUALFA. The Hcp100 nested PCR was performed on 393, 343, 75 and 297, blood, bone marrow, tissue and urine samples respectively; the sensitivity/specificity values obtained were 62.9% (95%CI, 53.3–72.5)/ 89.5% (95%CI, 86.0–93.0), 65.9% (95%CI, 56.0–75.8)/ 89.0% (95%CI, 85.2–92.9), 62.1% (95%CI, 44.4–79.7)/ 82.6% (95%CI, 71.7–93.6) and 34.9% (95%CI, 24.8–46.2)/ 67.3% (95%CI, 60.6–73.5) respectively; and 1281-1283220SCAR nested PCR was performed on 392, 344, 75 and 291, respectively; the sensitivity/specificity values obtained were 65.3% (95% CI, 55.9–74.7)/ 58.8% (95%CI, 53.2–64.5), 70.8% (95%CI, 61.3–80.2)/ 52.9% (95%CI, 46.8–59.1), 71.4% (95%CI, 54.7–88.2)/ 40.4% (95%CI, 26.4–54.5) and 18.1% (95%CI, 10.5–28.1)/ 90.4% (95%CI, 85.5–94.0), respectively. Conclusions/Significance The cHGEI IMMY and MVHUALFA tests showed excellent performance for the diagnosis of PDH in PLWHIV. The integration of these tests in clinical laboratories will certainly impact on early diagnosis and treatment.

scholarly journals An Italian Case of Disseminated Histoplasmosis Associated with HIV

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Chiara Papalini ◽  
Barbara Belfiori ◽  
Giovanni Martino ◽  
Rita Papili ◽  
Lucia Pitzurra ◽  
...  
Keyword(s):  
Histoplasma Capsulatum ◽  
Opportunistic Infections ◽  
Culture Method ◽  
Peripheral Blood Smear ◽  
Smear Microscopy ◽  
Dimorphic Fungus ◽  
Italian Case ◽  
Disseminated Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis ◽  
One Year

Histoplasma capsulatum is a dimorphic fungus, endemic in the Americas, Africa (var. duboisii), India, and Southeast Asia. H. capsulatum infection is rarely diagnosed in Italy, while in Latin America, progressive disseminated histoplasmosis (PDH) is one of the most frequent AIDS-defining illnesses and causes of AIDS-related deaths. We report a case of PDH and new HIV infection diagnosis in a Cuban patient, who has been living in Italy for the past 10 years. Bone marrow aspirate and peripheral blood smear microscopy suggested H. capsulatum infection. The diagnosis was confirmed with the culture method identifying its thermal dimorphism. Liposomal amphotericin B was administered alone for 10 days and then for another 2 days, accompanied with voriconazole; the former was stopped for probable side effects (persistent fever and worsening thrombocytopenia), and voriconazole was continued to complete 4 weeks. PDH maintenance treatment consisted of itraconazole for one year. Antiretroviral therapy (ART) was started on the third week of antifungal treatment. At the 3-year follow-up, the patient is adherent on ART, the virus was suppressed, and she has an optimal immune recovery. This case highlights the need to suspect histoplasmosis in the differential diagnosis of opportunistic infections in immunocompromised persons, native to or who have traveled to endemic countries.

scholarly journals Smoking-Cessation Interventions in People Living With HIV Infection: A Systematic Review

2014 ◽  
Vol 25 (1) ◽  
pp. 32-45 ◽  
Author(s):  
Gyasi Moscou-Jackson ◽  
Yvonne Commodore-Mensah ◽  
Jason Farley ◽  
Michelle DiGiacomo
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Hiv Infection ◽  
People Living With Hiv ◽  
Living With Hiv

Disseminated histoplasmosis and tuberculosis: dual infection in a non-endemic region

2020 ◽  
Vol 13 (8) ◽  
pp. e235531
Author(s):  
Karuna Anot ◽  
Sanjana Sharma ◽  
Monica Gupta ◽  
Daljinderjit Kaur
Keyword(s):  
Histoplasma Capsulatum ◽  
Organ Transplant ◽  
Dual Infection ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Dimorphic Fungus ◽  
Endemic Region ◽  
Systemic Fungal Infection ◽  
Disseminated Histoplasmosis ◽  
Solid Organ Transplant Recipients

Histoplasmosis is a systemic fungal infection caused by Histoplasma capsulatum, a dimorphic fungus that spreads commonly by contamination of soil with bird and bat droppings. The infection remains latent in most patients until manifested by reduced immune status, for example, HIV/AIDS, corticosteroid/immunosuppressive therapy or in solid organ transplant recipients. Tuberculosis and histoplasmosis may cooccur rarely in HIV and the clinical resemblance of both diseases may hinder identification of patients’ harbouring dual infection, especially in regions non-endemic for histoplasmosis. We report a case of disseminated histoplasmosis with disseminated tuberculosis in an incidentally detected patient with HIV-positive who presented with reports of fever and skin rash for 10 days. The Mantoux positivity and CT of chest and abdomen revealing multiple necrotic lymph nodes coupled with bone marrow and skin biopsy divulging histoplasmosis and tuberculosis helped us clinch the concurrent infection.

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