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Cáceres DH, Gómez BL, Tobón ÁM, Restrepo Á, Chiller T, Lindsley MD, Meis JF, Verweij PE. Tackling Histoplasmosis Infection in People Living with HIV from Latin America: From Diagnostic Strategy to Public Health Solutions. J Fungi (Basel) 2023; 9:jof9050558. [PMID: 37233269 DOI: 10.3390/jof9050558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/27/2023] Open
Abstract
Histoplasmosis, caused by the thermally dimorphic fungus Histoplasma spp., is a disease with a broad clinical spectrum, presenting from asymptomatic/flu-like symptoms to progressive disseminated disease in people with immunosuppression. In recent years, the concept of histoplasmosis as a disease restricted to the American continent has changed, as now histoplasmosis is reported in many regions around the world. In Latin America, histoplasmosis represents a threat, especially in people with advanced HIV disease (AHD). Diagnosis of histoplasmosis in people living with HIV (PLHIV) is challenging due to the low index of suspicion of the disease, non-specificity of signs and symptoms, and limited access to specific laboratory testing, while the diagnostic delay is significantly associated with mortality. In the last decade, novel diagnostic tests have been developed for the rapid detection of histoplasmosis, such as commercial kits for antigen detection. Furthermore, advocacy groups were created that presented histoplasmosis as a public health problem, with emphasis on patients at risk of progressive disseminated disease. This review aims to discuss the impact of histoplasmosis associated with AHD in Latin America and the strategies employed to tackle histoplasmosis, from the implementation of laboratory testing to disease advocacy and public health interventions.
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Affiliation(s)
- Diego H Cáceres
- Center of Expertise in Mycology Radboudumc/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
- IMMY, Norman, OK 73069, USA
| | - Beatriz L Gómez
- Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota 111221, Colombia
| | - Ángela M Tobón
- Instituto Colombiano de Medicina Tropical, Universidad CES, Medellín 055450, Colombia
| | - Ángela Restrepo
- COLCIENCIAS Emeritus Researcher, Ministerio de Ciencias, Tecnología e Innovación, Bogota 111321, Colombia
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Mark D Lindsley
- Mycotic Diseases Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30329, USA
| | - Jacques F Meis
- Center of Expertise in Mycology Radboudumc/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
- Department I of Internal Medicine, Excellence Center for Medical Mycology, University Hospital Cologne, 50931 Cologne, Germany
| | - Paul E Verweij
- Center of Expertise in Mycology Radboudumc/Canisius Wilhelmina Hospital, 6532 SZ Nijmegen, The Netherlands
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Ferrisse TM, Rocha AFL, Miotto LN, de Almeida Lança ML, Massucato EMS, Bufalino A. Disseminated Histoplasmosis Infection in HIV-Negative Patients: Series Case and Literature Review. CURRENT FUNGAL INFECTION REPORTS 2021. [DOI: 10.1007/s12281-021-00414-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Almeida MDA, Almeida-Silva F, Guimarães AJ, Almeida-Paes R, Zancopé-Oliveira RM. The occurrence of histoplasmosis in Brazil: A systematic review. Int J Infect Dis 2019; 86:147-156. [PMID: 31330326 DOI: 10.1016/j.ijid.2019.07.009] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 07/09/2019] [Accepted: 07/13/2019] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Histoplasmosis is a systemic disease caused by the dimorphic fungus Histoplasma capsulatum. Diagnosis is often delayed, or it is misdiagnosed as tuberculosis. In Brazil, the infection is common and cases of histoplasmosis have been described in all regions of the country; however, the real problem is underestimated since notification of histoplasmosis is not mandatory. METHODS Human histoplasmosis cases diagnosed in Brazil and published up to December 2018 were identified through a search conducted in the PubMed/MEDLINE, SciELO, and Web of Science databases. Moreover, the isolation of H. capsulatum from animals or environmental sources in Brazil was also evaluated. RESULTS A total of 207 articles fulfilled the inclusion criteria and were evaluated, involving a total of 3530 patients with a diagnosis of histoplasmosis during the period studied. Of these patients, 78.3% were male, giving a male-to-female ratio of approximately 4:1. Histoplasmosis presented a higher frequency in individuals between the fourth and fifth decades of life. Disseminated disease was the most common form of histoplasmosis. Isolation of H. capsulatum on culture media and histopathology using staining methods were the diagnostic methods with the best efficiency. The best results in the identification of the H. capsulatum were achieved for samples from mononuclear phagocyte system components, skin and mucosa, and hematological samples. Regarding predisposing factors for histoplasmosis, HIV infection was the most common underlying condition. The overall mortality rate was 33.1%. CONCLUSIONS This study represents the first available systematic review demonstrating Brazilian cases of histoplasmosis in the literature and highlights that the disease is more widespread in the Brazilian territory than has previously been thought.
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Affiliation(s)
- Marcos de Abreu Almeida
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Fernando Almeida-Silva
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | | | - Rodrigo Almeida-Paes
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Rosely Maria Zancopé-Oliveira
- Laboratório de Micologia, Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
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Kalyana Chakravarthy S, Jayasudha R, Ranjith K, Dutta A, Pinna NK, Mande SS, Sharma S, Garg P, Murthy SI, Shivaji S. Alterations in the gut bacterial microbiome in fungal Keratitis patients. PLoS One 2018; 13:e0199640. [PMID: 29933394 PMCID: PMC6014669 DOI: 10.1371/journal.pone.0199640] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 06/11/2018] [Indexed: 12/12/2022] Open
Abstract
Dysbiosis in the gut microbiome has been implicated in several diseases including auto-immune diseases, inflammatory diseases, cancers and mental disorders. Keratitis is an inflammatory disease of the eye significantly contributing to corneal blindness in the developing world. It would be worthwhile to investigate the possibility of dysbiosis in the gut microbiome being associated with Keratitis. Here, we have analyzed fungal and bacterial populations in stool samples through high-throughput sequencing of the ITS2 region for fungi and V3-V4 region of 16S rRNA gene for bacteria in healthy controls (HC, n = 31) and patients with fungal keratitis (FK, n = 32). Candida albicans (2 OTUs), Aspergillus (1 OTU) and 3 other denovo-OTUs were enriched in FK samples and an unclassified denovo-OTU was enriched in HC samples. However, the overall abundances of these ‘discriminatory’ OTUs were very low (< 0.001%) and not indicative of significant dysbiosis in the fungal community inhabiting the gut of FK patients. In contrast, the gut bacterial richness and diversity in FK patients was significantly decreased when compared to HC. 52 OTUs were significantly enriched in HC samples whereas only 5 OTUs in FK. The OTUs prominently enriched in HC were identified as Faecalibacterium prausnitzii, Bifidobacterium adolescentis, Lachnospira, Mitsuokella multacida, Bacteroides plebeius, Megasphaera and Lachnospiraceae. In FK samples, 5 OTUs affiliated to Bacteroides fragilis, Dorea, Treponema, Fusobacteriaceae, and Acidimicrobiales were significantly higher in abundance. The functional implications are that Faecalibacterium prausnitzii, an anti-inflammatory bacterium and Megasphaera, Mitsuokella multacida and Lachnospira are butyrate producers, which were enriched in HC patients, whereas Treponema and Bacteroides fragilis, which are pathogenic were abundant in FK patients, playing a potential pro-inflammatory role. Heatmap, PCoA plots and functional profiles further confirm the distinct patterns of gut bacterial composition in FK and HC samples. Our study demonstrates dysbiosis in the gut bacterial microbiomes of FK patients compared to HC. Further, based on inferred functions, it appears that dysbiosis in the gut of FK subjects is strongly associated with the disease phenotype with decrease in abundance of beneficial bacteria and increase in abundance of pro-inflammatory and pathogenic bacteria.
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Affiliation(s)
- Sama Kalyana Chakravarthy
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy campus, Hyderabad, India
| | - Rajagopalaboopathi Jayasudha
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy campus, Hyderabad, India
| | - Konduri Ranjith
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy campus, Hyderabad, India
| | - Anirban Dutta
- Bio-Sciences R&D Division, TCS Research, Tata Consultancy Services Ltd., Pune, India
| | - Nishal Kumar Pinna
- Bio-Sciences R&D Division, TCS Research, Tata Consultancy Services Ltd., Pune, India
| | - Sharmila S. Mande
- Bio-Sciences R&D Division, TCS Research, Tata Consultancy Services Ltd., Pune, India
| | - Savitri Sharma
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy campus, Hyderabad, India
| | - Prashant Garg
- Tej Kohli Cornea Institute, L. V. Prasad Eye Institute, Kallam Anji Reddy campus, Hyderabad, India
| | - Somasheila I. Murthy
- Tej Kohli Cornea Institute, L. V. Prasad Eye Institute, Kallam Anji Reddy campus, Hyderabad, India
| | - Sisinthy Shivaji
- Jhaveri Microbiology Centre, Brien Holden Eye Research Centre, L. V. Prasad Eye Institute, Kallam Anji Reddy campus, Hyderabad, India
- * E-mail:
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Boigues BCS, Paniago AMM, Lima GME, Nunes MDO, Uehara SNDO. Clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with AIDS who visited a high-complexity hospital in Campo Grande, MS, Brazil. Rev Soc Bras Med Trop 2018; 51:155-161. [PMID: 29768547 DOI: 10.1590/0037-8682-0369-2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 03/20/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Disseminated histoplasmosis (DH) is a systemic mycosis caused by Histoplasma capsulatum (H. capsulatum) and is characterized by progressive and fatal evolution in immunocompromised patients. Moreover, it is considered an AIDS-defining disease. METHODS We performed an observational, analytical, retrospective study to identify the clinical outcomes and risk factors for death from DH in patients with AIDS at an infectious diseases service facility in Brazil between September 2011 and July 2016. Patients with a positive serology for HIV and DH were diagnosed via direct examination and/or positive cultures for H. capsulatum. RESULTS Twenty-three patients were included in this study. Approximately, 82.6% were men, with a mean age of 41.0±11.5 years, and 52.2% had a concomitant diagnosis of AIDS and DH. The median CD4+ T cell count was 19 cells/mm3, and 56.5% of the patients died. The most frequently observed symptoms were fever, dyspnea, and skin lesions. On the basis of a comparative analysis of those who died and survived, the absence of splenomegaly and hepatomegaly and the presence of H. capsulatum in the peripheral blood were considered as risk factors for death. Those who died had a higher leukocyte count; CRP, urea, and lactate dehydrogenase levels; AST index; and international normalized ratio prothrombin time. The serum total protein and albumin levels of the patients were lower. CONCLUSIONS The mortality rate for DH is high among severely immunocompromised patients with AIDS. The risk factors for death were those traditionally associated with blood dyscrasia, inflammatory activity, as well as increased renal and nutritional impairment.
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Affiliation(s)
| | | | | | - Maina de Oliveira Nunes
- Laboratório de Micologia Médica, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brasil
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Caceres DH, Tobón AM, Cleveland AA, Scheel CM, Berbesi DY, Ochoa J, Restrepo A, Brandt ME, Chiller T, Gómez BL. Clinical and Laboratory Profile of Persons Living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome and Histoplasmosis from a Colombian Hospital. Am J Trop Med Hyg 2016; 95:918-924. [PMID: 27481056 PMCID: PMC5062801 DOI: 10.4269/ajtmh.15-0837] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 05/12/2016] [Indexed: 11/07/2022] Open
Abstract
Histoplasmosis is common among persons living with human immunodeficiency virus/acquired immune deficiency syndrome (PLWHA) in Latin America, but its diagnosis is difficult and often nonspecific. We conducted prospective screening for histoplasmosis among PLWHA with signs or symptoms suggesting progressive disseminated histoplasmosis (PDH) and hospitalized in Hospital La María in Medellín, Colombia. The study's aim was to obtain a clinical and laboratory profile of PLWHA with PDH. During 3 years (May 2008 to August 2011), we identified 89 PLWHA hospitalized with symptoms suggestive of PDH, of whom 45 (51%) had histoplasmosis. We observed tuberculosis (TB) coinfection in a large proportion of patients with PDH (35%), so all analyses were performed adjusting for this coinfection and, alternatively, excluding histoplasmosis patients with TB. Results showed that the patients with PDH were more likely to have Karnofsky score ≤ 30 (prevalence ratio [PR] = 1.98, 95% confidence interval [CI] = 0.97-4.06), liver compromised with hepatomegaly and/or splenomegaly (PR = 1.77, CI = 1.03-3.06) and elevation in serum of alanine aminotransferase and aspartate aminotransferase to values > 40 mU/mL (PR = 2.06, CI = 1.09-3.88 and PR = 1.53, CI = 0.99-2.35, respectively). Using multiple correspondence analyses, we identified in patients with PDH a profile characterized by the presence of constitutional symptoms, namely weight loss and Karnofsky classification ≤ 30, gastrointestinal manifestations with alteration of liver enzymes and hepatosplenomegaly and/or splenomegaly, skin lesions, and hematological alterations. Study of the profiles is no substitute for laboratory diagnostics, but identifying clinical and laboratory indicators of PLWHA with PDH should allow development of strategies for reducing the time to diagnosis and thus mortality caused by Histoplasma capsulatum.
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Affiliation(s)
- Diego H Caceres
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia. School of Medicine, Universidad CES, Medellín, Colombia
| | - Angela M Tobón
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia. Hospital La María, Medellín, Colombia
| | | | - Christina M Scheel
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Jesús Ochoa
- Facultad Nacional de Salud Pública, Universidad de Antioquia, Medellín, Colombia
| | - Angela Restrepo
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia
| | - Mary E Brandt
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Tom Chiller
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Beatriz L Gómez
- Medical and Experimental Mycology Group, Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia. School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia.
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Silva TC, Treméa CM, Zara ALSA, Mendonça AF, Godoy CSM, Costa CR, Souza LKH, Silva MRR. Prevalence and lethality among patients with histoplasmosis and AIDS in the Midwest Region of Brazil. Mycoses 2016; 60:59-65. [PMID: 27625302 DOI: 10.1111/myc.12551] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/30/2016] [Accepted: 07/19/2016] [Indexed: 11/29/2022]
Abstract
Histoplasmosis is a systemic mycosis that is considered an important public health problem. In this work, we performed a descriptive, observational, cross-sectional and retrospective study with a secondary data analysis of medical records from 2000 to 2012 at a tertiary hospital. The study sample consisted of 275 patients with laboratory-confirmed Disseminated Histoplasmosis (DH)/AIDS. The results showed that the prevalence of DH associated with AIDS was 4.4%. The majority of patients were young adult men with fever in 84.2%, cough in 63.4%, weight loss in 63.1%, diarrhoea in 44.8% and skin manifestations in 27.6% of patients. In the overall cohort, the CD4 counts were low, but not significantly different in survivors and non-survivors. Higher levels of urea and lower levels of haemoglobin and platelets were observed in non-survivor patients (<.05). The global lethality was 71.3% (196/275). The results with high prevalence and lethality highlight the need to adopt measures to facilitate early diagnosis, proper treatment and improved prognosis.
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Affiliation(s)
- Thaísa C Silva
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiania, Goiás, Brazil
| | - Carolina M Treméa
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiania, Goiás, Brazil
| | - Ana Laura S A Zara
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiania, Goiás, Brazil
| | | | - Cássia S M Godoy
- Hospital of Tropical Diseases "Dr. Anuar Auad", Goiania, Goiás, Brazil
| | - Carolina R Costa
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiania, Goiás, Brazil
| | - Lúcia K H Souza
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiania, Goiás, Brazil
| | - Maria R R Silva
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiania, Goiás, Brazil
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Nunes JDO, Pillon KRAP, Bizerra PL, Paniago AMM, Mendes RP, Chang MR. The Simultaneous Occurrence of Histoplasmosis and Cryptococcal Fungemia: A Case Report and Review of the Literature. Mycopathologia 2016; 181:891-897. [PMID: 27423433 DOI: 10.1007/s11046-016-0036-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 06/29/2016] [Indexed: 12/11/2022]
Abstract
Simultaneous infections with Cryptococcus neoformans and Histoplasma capsulatum are rare and typically occur in immunocompromised individuals, particularly AIDS patients. Because both of those fungi can spur the development of latent infections, it is generally unknown which organism was first present. The diagnosis of one fungus can hide the diagnosis of the other, leading to underdiagnoses and poor prognosis. We report a case of C. neoformans and H. capsulatum co-infection. We also performed a systematic review of the literature. Our patient, a 69-year-old HIV-negative man, presented with a 9-month history of a productive cough, dyspnea and wheezing. His history showed chronic obstructive pulmonary disease and type II diabetes mellitus (DM). Pulmonary lesions of unidentified etiology were noted. Cryptococcal involvement of the central nervous system was confirmed, and C. neoformans and H. capsulatum were also isolated from blood cultures. In the literature, we found ten cases of simultaneous histoplasmosis and cryptococcosis. Including our patient, all of the cases were located in North America and Latin America, except for two, one Indian and one African diagnosed in France. AIDS was the main predisposing factor, followed by DM and age >60 years. Several diagnostic methods were employed. A blood culture and bronchoalveolar lavage (BAL) culture resulted in the growth of C. neoformans in most of the cases. H. capsulatum was more often detected in BAL and bone marrow cultures. Although co-infection by these pathogens is severe, it can be cured if it is diagnosed and treated early. We emphasized the importance of clinical suspicion and differential diagnosis of systemic mycoses.
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Affiliation(s)
- Joslaine de Oliveira Nunes
- Universidade Federal de Mato Grosso do Sul, Rua Alberto José Abrão, 53, Campo Grande, MS, 79081-732, Brazil.
| | | | - Patrícia Lira Bizerra
- Universidade Federal de Mato Grosso do Sul, Rua Alberto José Abrão, 53, Campo Grande, MS, 79081-732, Brazil
| | | | - Rinaldo Poncio Mendes
- Researcher of Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Marilene Rodrigues Chang
- Microbiological Research Laboratory, Universidade Federal de Mato Grosso do Sul, Campo Grande, MS, Brazil
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Klein IP, Martins MAT, Martins MD, Carrard VC. Diagnosis of HIV infection on the basis of histoplasmosis-related oral ulceration. SPECIAL CARE IN DENTISTRY 2015; 36:99-103. [PMID: 26597996 DOI: 10.1111/scd.12147] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Histoplasmosis is an endemic systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum. In immunocompromised patients, histoplasmosis generally occurs as an opportunistic disease, with dissemination to various organs. Cutaneous involvement is observed in 38% to 85% of cases, with oral mucosal involvement in 30% to 60% of cases. This article describes the case study of a 32-year-old woman who presented an extensive tongue ulcer due to histoplasmosis and had the HIV infection diagnosis based on laboratory tests requested by the dentist.
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Affiliation(s)
- Isadora Peres Klein
- Master's degree student, Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Marco Antonio Trevizani Martins
- Assistant professor, Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Manoela Domingues Martins
- Assistant professor, Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Vinicius Coelho Carrard
- Assistant professor, Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Furuie JL, Sun J, do Nascimento MMF, Gomes RR, Waculicz-Andrade CE, Sessegolo GC, Rodrigues AM, Galvão-Dias MA, de Camargo ZP, Queiroz-Telles F, Najafzadeh MJ, de Hoog SG, Vicente VA. Molecular identification of Histoplasma capsulatum using rolling circle amplification. Mycoses 2015; 59:12-9. [PMID: 26578301 DOI: 10.1111/myc.12426] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 09/30/2015] [Accepted: 10/03/2015] [Indexed: 12/01/2022]
Abstract
Histoplasmosis is a systemic fungal disease that occurs worldwide, causing symptomatic infection mostly in immunocompromised hosts. Etiological agent is the dimorphic fungus, Histoplasma capsulatum, which occurs in soil contaminated with bird or bat droppings. Major limitation in recognition of H. capsulatum infections is the low awareness, since other diseases may have similar symptomatology. The molecular methods have gained importance because of unambiguous diagnostic ability and efficiency. The aim of this study was to develop and evaluate a padlock probe in view of rolling circle amplification (RCA) detection method which targets ITS (Internal Transcribed Spacer) rDNA of H. capsulatum enabling rapid and specific detection of the fungus in clinical samples. Two padlock probes were designed and one of these (HcPL2) allowed specific amplification of H. capsulatum DNA while no cross-reactivity was observed with fungi used as negative controls. This method proved to be effective for H. capsulatum specific identification and demonstrated to be faster than the traditional method of microbiological identification.
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Affiliation(s)
- Jason L Furuie
- Bioprocess Engineering and Biotechnology Department, Post-Graduation Program of Bioprocess Engineering and Biotechnology, Federal University of Paraná, Curitiba, Brazil
| | - Jiufeng Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Mariana M F do Nascimento
- Basic Pathology Department, Post-Graduation Program of Microbiology, Parasitology and Pathology, Federal University of Paraná, Curitiba, Brazil
| | - Renata R Gomes
- Basic Pathology Department, Post-Graduation Program of Microbiology, Parasitology and Pathology, Federal University of Paraná, Curitiba, Brazil
| | - Caroline E Waculicz-Andrade
- Basic Pathology Department, Post-Graduation Program of Microbiology, Parasitology and Pathology, Federal University of Paraná, Curitiba, Brazil
| | | | - Anderson M Rodrigues
- Cellular Biology Division, Microbiology, Immunology and Parasitology Department, Federal University of São Paulo, São Paulo, Brazil
| | | | - Zoilo P de Camargo
- Cellular Biology Division, Microbiology, Immunology and Parasitology Department, Federal University of São Paulo, São Paulo, Brazil
| | - Flávio Queiroz-Telles
- Basic Pathology Department, Post-Graduation Program of Microbiology, Parasitology and Pathology, Federal University of Paraná, Curitiba, Brazil.,Clinical Hospital of the Federal University of Paraná, Curitiba, Brazil
| | - Mohammad J Najafzadeh
- Parasitology and Mycology Department, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sybren G de Hoog
- Basic Pathology Department, Post-Graduation Program of Microbiology, Parasitology and Pathology, Federal University of Paraná, Curitiba, Brazil.,CBS-KNAW Fungal Biodiversity Centre, Utrecht, The Netherlands
| | - Vania A Vicente
- Bioprocess Engineering and Biotechnology Department, Post-Graduation Program of Bioprocess Engineering and Biotechnology, Federal University of Paraná, Curitiba, Brazil.,Basic Pathology Department, Post-Graduation Program of Microbiology, Parasitology and Pathology, Federal University of Paraná, Curitiba, Brazil
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13
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Fabris LR, Andrade ÚV, Ferreira Dos Santos A, Marques APDC, Oliveira SMDVLD, Mendes RP, Paniago AMM. Decreasing prevalence of the acute/subacute clinical form of paracoccidioidomycosis in Mato Grosso do Sul State, Brazil. Rev Inst Med Trop Sao Paulo 2014; 56:121-5. [PMID: 24626413 PMCID: PMC4085850 DOI: 10.1590/s0036-46652014000200006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 08/05/2013] [Indexed: 05/28/2023] Open
Abstract
With the objective to evaluate the behavior of paracoccidioidomycosis
in the last three decades, clinical and epidemiological data of 595 patients
admitted to clinical services of the Federal University of Mato Grosso do Sul
from 1980 to 2009 were investigated. Gender, age distribution, clinical form,
comorbidity with tuberculosis or AIDS, and mortality were compared by decades of
clinical admission. It was shown that during the three decades there was a
decrease in women percentage, and the same manner occurred a reduction in
participants in the age group of 20 to 39 years. Moreover, the acute/subacute
forms have been diminished in the period. These fluctuations are closely related
and can be simultaneously analyzed. Increased AIDS co-infection prevalence from
the first to the second decade was also revealed, coinciding with the appearance
of the retroviral epidemic and stabilizing during the third decade. No change in
the tuberculosis co-infection rate was observed (overall = 6.9%). It
reinforces the importance of this co-morbidity. The overall mortality rate
remained steady at 6.7%, not varying significantly from one decade to another.
The persistent mortality rate calls attention to the importance of this
neglected disease.
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Affiliation(s)
- Larissa Rodrigues Fabris
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul (UFMS), Campo GrandeMS, Brazil, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil. E-mails: , , , ,
| | - Úrsulla Vilella Andrade
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul (UFMS), Campo GrandeMS, Brazil, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil. E-mails: , , , ,
| | - Aline Ferreira Dos Santos
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul (UFMS), Campo GrandeMS, Brazil, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil. E-mails: , , , ,
| | - Ana Paula da Costa Marques
- Centro de Ciências Biológicas e da Saúde, Universidade Federal de Mato Grosso do Sul, Campo Grande (UFMS)MS, Brazil, Centro de Ciências Biológicas e da Saúde, Universidade Federal de Mato Grosso do Sul, Campo Grande (UFMS), MS, Brazil. E-mail:
| | - Sandra Maria do Valle Leone de Oliveira
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul (UFMS), Campo GrandeMS, Brazil, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil. E-mails: , , , ,
| | - Rinaldo Pôncio Mendes
- Faculdade de Medicina, Universidade Estadual Paulista (UNESP), BotucatuSP, Brazil, Faculdade de Medicina, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil. E-mail:
| | - Anamaria Mello Miranda Paniago
- Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul (UFMS), Campo GrandeMS, Brazil, Faculdade de Medicina, Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil. E-mails: , , , ,
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Faiolla RCL, Coelho MC, Santana RDC, Martinez R. Histoplasmosis in immunocompetent individuals living in an endemic area in the Brazilian Southeast. Rev Soc Bras Med Trop 2014; 46:461-5. [PMID: 23982099 DOI: 10.1590/0037-8682-0124-2013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 07/26/2013] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The distribution of infection by Histoplasma capsulatum in Brazil is heterogeneous, and the number of cases affecting immunocompetent individuals is relatively small. This study reports the epidemiological and clinical data regarding histoplasmosis in non-immunosuppressed individuals. METHODS The study included only the immunocompetent patients with histoplasmosis who were diagnosed between 1970 and 2012 at a university hospital located in Ribeirão Preto, State of São Paulo, Brazil. Clinical and epidemiological data were collected retrospectively from the patient records. RESULTS Of the 123 patients analyzed, 95 had an active disease that manifested in the different clinical forms of histoplasmosis. Men were the predominant gender, and most patients resided in the Northeast of the State of São Paulo and in the nearby municipalities of the State of Minas Gerais. The risk factors for acquiring histoplasmosis and prolonged contact in a rural environment were recorded in 43.9% and 82.9% of cases, respectively. Smoking, alcoholism, and comorbidity rates were high among the patients with the chronic pulmonary and subacute/chronic disseminated forms of histoplasmosis. Many patients achieved clinical cure spontaneously, but 58.9% required antifungals; the disease lethality rate was 5.3%. CONCLUSIONS Immunocompetent individuals manifested the diverse clinical forms of histoplasmosis over a period of 4 decades, revealing an additional endemic area of this fungal disease in the Brazilian Southeast.
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Affiliation(s)
- Rivian Christina Lopes Faiolla
- Divisão de Moléstias Infecciosas e Tropicais, Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina de Ribeiro Preto, Universidade de São Paulo, Ribeirão Preto, SP
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15
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Development of a loop-mediated isothermal amplification method for detection of Histoplasma capsulatum DNA in clinical samples. J Clin Microbiol 2013; 52:483-8. [PMID: 24478477 DOI: 10.1128/jcm.02739-13] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Improved methods for the detection of Histoplasma capsulatum are needed in regions with limited resources in which the organism is endemic, where delayed diagnosis of progressive disseminated histoplasmosis (PDH) results in high mortality rates. We have investigated the use of a loop-mediated isothermal amplification (LAMP) assay to facilitate rapid inexpensive molecular diagnosis of this disease. Primers for LAMP were designed to amplify the Hcp100 locus of H. capsulatum. The sensitivity and limit of detection were evaluated using DNA extracted from 91 clinical isolates of known geographic subspecies, while the assay specificity was determined using DNA extracted from 50 other fungi and Mycobacterium tuberculosis. Urine specimens (n = 6) collected from HIV-positive individuals with culture- and antigen-proven histoplasmosis were evaluated using the LAMP assay. Specimens from healthy persons (n = 10) without evidence of histoplasmosis were used as assay controls. The Hcp100 LAMP assay was 100% sensitive and specific when tested with DNA extracted from culture isolates. The median limit of detection was ≤6 genomes (range, 1 to 300 genomes) for all except one geographic subspecies. The LAMP assay detected Hcp100 in 67% of antigen-positive urine specimens (4/6 specimens), and results were negative for Hcp100 in all healthy control urine specimens. We have shown that the Hcp100 LAMP assay is a rapid affordable assay that can be used to expedite culture confirmation of H. capsulatum in regions in which PDH is endemic. Further, our results indicate proof of the concept that the assay can be used to detect Histoplasma DNA in urine. Further evaluation of this assay using body fluid samples from a larger patient population is warranted.
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Cota GF, de Sousa MR, de Freitas Nogueira BM, Gomes LI, Oliveira E, Assis TSM, de Mendonça ALP, Pinto BF, Saliba JW, Rabello A. Comparison of parasitological, serological, and molecular tests for visceral leishmaniasis in HIV-infected patients: a cross-sectional delayed-type study. Am J Trop Med Hyg 2013; 89:570-7. [PMID: 23836568 DOI: 10.4269/ajtmh.13-0239] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The aim of this study was to evaluate the accuracy of invasive and non-invasive tests for diagnosis of visceral leishmaniasis (VL) in a large series of human immunodeficiency virus (HIV)-infected patients. In this delayed-type cross-sectional study, 113 HIV-infected symptomatic patients were evaluated by an adjudication committee after clinical follow-up to establish the presence or absence of VL as the target condition (reference test). The index tests were recombinant K39 antigen-based immunochromatographic test (rK39), indirect fluorescent antibody test (IFAT), prototype kit of direct agglutination test (DAT-LPC), and real-time polymerase chain reaction (qPCR) in peripheral blood. Compared with parasitological test and adjudication committee diagnosis or latent class model analyses, IFAT and rk39 dipstick test presented the lowest sensitivity. DAT-LPC exhibited good overall performance, and there was no statistical difference between DAT-LPC and qPCR diagnosis accuracy. Real-time PCR emerges as a less invasive alternative to parasitological examination for confirmation of cases not identified by DAT.
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Affiliation(s)
- Gláucia Fernandes Cota
- Eduardo de Menezes Hospital, Fundação Hospitalar do Estado de Minas Gerais (FHEMIG), Belo Horizonte, Minas Gerais, Brazil.
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17
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Bezerra FS, Zancope-Oliveira RM, Brilhante RSN, Wanke B, Mota RMS, Ramos APG, Ramos Jr. AN, Facanha MC, Leitao TDMJS. HISTOPLASMIN SURVEY IN HIV-POSITIVE PATIENTS: RESULTS FROM AN ENDEMIC AREA IN NORTHEASTERN BRAZIL. Rev Inst Med Trop Sao Paulo 2013. [DOI: 10.1590/s0036-46652013000400007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY Background. Disseminated histoplasmosis is common in AIDS patients with advanced immunosuppression in Ceará, Northeastern Brazil. The goal of this study was to determine the prevalence of Histoplasma infection in patients with HIV/AIDS living in Fortaleza, the capital of Ceará. Methods. Intradermal tests with histoplasmin (mycelial phase) were performed in 161 HIV patients with CD4 ≥ 350 cells/mm 3 . Evidence of recent illness was evaluated with immunodiffusion (ID) tests in 76 of these individuals. Results. A total of 11.8% of patients reacted to histoplasmin and 2.63% had ID test positive to Histoplasma. The presence of mango trees (Mangifera indica) in the patient neighborhood (OR = 2.870; 95% CI = 1.081-7.617; p = 0.040) and past activity involving soil (OR = 2.834; 95% CI = 1.045-7.687; p = 0.045) or visits to a farm (OR = 3.869; 95% CI = 1.189-12.591; p = 0.033) were significantly associated with Histoplasma infection. Conclusions. Patients with HIV living in Fortaleza have an expressive prevalence of infection with Histoplasma.
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Dasmasceno LS, Novaes Jr AR, Alencar CHM, Lima DT, Sidrim JJC, Gonçalves MVF, de Mesquita JRL, Leitão TDMJS. Disseminated histoplasmosis and aids: relapse and late mortality in endemic area in north-eastern Brazil. Mycoses 2013; 56:520-6. [DOI: 10.1111/myc.12067] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 02/03/2013] [Accepted: 02/07/2013] [Indexed: 11/27/2022]
Affiliation(s)
| | - Alberto Ramos Novaes Jr
- Department of Community Health; School of Medicine; Federal University of Ceará; Fortaleza; CE; Brazil
| | | | - Daniel Teixeira Lima
- Specialized Medical Mycology Center; Federal University of Ceará; Fortaleza; CE; Brazil
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Histoplasmosis y sida: factores de riesgo clínicos y de laboratorio asociados al pronóstico de la enfermedad. INFECTIO 2012. [DOI: 10.1016/s0123-9392(12)70026-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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20
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Cavalcanti ATDAE, Medeiros Z, Lopes F, Andrade LDD, Ferreira VDM, Magalhães V, Miranda-Filho DDB. Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil. Rev Inst Med Trop Sao Paulo 2012; 54:43-7. [PMID: 22370753 DOI: 10.1590/s0036-46652012000100008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2011] [Accepted: 12/14/2011] [Indexed: 11/21/2022] Open
Abstract
HIV/AIDS-associated visceral leishmaniasis may display the characteristics of an aggressive disease or without specific symptoms at all, thus making diagnosis difficult. The present study describes the results of diagnostic tests applied to a series of suspected VL cases in HIV-infected/AIDS patients admitted in referral hospitals in Pernambuco, Brazil. From a total of 14 eligible patients with cytopenias and/or fever of an unknown etiology, and indication of bone marrow aspirate, 10 patients were selected for inclusion in the study. Diagnosis was confirmed by the following examinations: Leishmania detection in bone marrow aspirate, direct agglutination test, indirect immunofluorescence, rK39 dipstick test, polymerase chain reaction and latex agglutination test. Five out of the ten patients were diagnosed with co-infection. A positive direct agglutination test was recorded for all five co-infected patients, the Leishmania detection and latex agglutination tests were positive in four patients, the rK39 dipstick test in three, the indirect immunofluorescence in two and a positive polymerase chain reaction was recorded for one patient. This series of cases was the first to be conducted in Brazil using this set of tests in order to detect co-infection. However, no consensus has thus far been reached regarding the most appropriate examination for the screening and monitoring of this group of patients.
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Brilhante RSN, Ribeiro JF, Lima RAC, Castelo-Branco DSCM, Soares RM, Mesquita JRL, Grangeiro TB, de Camargo ZP, Cordeiro RA, Rocha MFG, Sidrim JJC. Evaluation of the genetic diversity of Histoplasma capsulatum var. capsulatum isolates from north-eastern Brazil. J Med Microbiol 2012; 61:1688-1695. [PMID: 22977075 DOI: 10.1099/jmm.0.044073-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Since the beginning of the HIV epidemic, there has been a significant increase in the number of histoplasmosis cases in Ceará, a state in north-east Brazil. The lack of epidemiological data on the genotypes circulating in the north-east region shows the importance of more detailed studies on the molecular epidemiology of Histoplasma capsulatum var. capsulatum in this region. Different molecular techniques have been used to better characterize the genetic profile of H. capsulatum var. capsulatum strains. The aim of this study was to analyse the genetic diversity of H. capsulatum var. capsulatum isolates in Fortaleza, the capital of Ceará, through the sequencing of the internal transcribed spacer (ITS)1-5.8S-ITS2 region, and establish the molecular profile of these isolates, along with strains from south-east Brazil, by RAPD analysis, featuring the different clusters in those regions. The isolates were grouped into two clusters. Cluster 1 included strains from the south-east and north-east regions with separation of isolates into three distinct subgroups (subgroups 1a, 1b and 1c). Cluster 2 included only samples from north-east Brazil. Sequencing of the ITS1-5.8S-ITS2 region allowed the detection of two major clades, which showed geographical correlation between them and their subgroups. Therefore, it can be concluded that the H. capsulatum var. capsulatum isolates from Ceará have a high degree of genetic polymorphism. The molecular data also confirm that populations of this fungus are composed of different genotypes in Brazil and worldwide.
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Affiliation(s)
- Raimunda S N Brilhante
- Department of Pathology and Legal Medicine, College of Medicine, Post-Graduation Program in Medical Microbiology, Specialized Medical Mycology Center, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Joyce F Ribeiro
- Department of Pathology and Legal Medicine, College of Medicine, Post-Graduation Program in Medical Microbiology, Specialized Medical Mycology Center, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Rita A C Lima
- Department of Pathology and Legal Medicine, College of Medicine, Post-Graduation Program in Medical Microbiology, Specialized Medical Mycology Center, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Débora S C M Castelo-Branco
- Department of Pathology and Legal Medicine, College of Medicine, Post-Graduation Program in Medical Microbiology, Specialized Medical Mycology Center, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Rodrigo Martins Soares
- Department of Preventive Veterinary Medicine and Animal Health, College of Veterinary Medicine, Universidade de São Paulo, São Paulo, Brazil
| | | | | | - Zoilo P de Camargo
- Department of Microbiology, Immunology and Parasitology, Federal University of São Paulo, São Paulo, Brazil
| | - Rossana A Cordeiro
- Department of Pathology and Legal Medicine, College of Medicine, Post-Graduation Program in Medical Microbiology, Specialized Medical Mycology Center, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Marcos F G Rocha
- College of Veterinary Medicine, Post-Graduation Program in Veterinary Sciences, Universidade Estadual do Ceará, Fortaleza, Ceará, Brazil.,Department of Pathology and Legal Medicine, College of Medicine, Post-Graduation Program in Medical Microbiology, Specialized Medical Mycology Center, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - José J C Sidrim
- Department of Pathology and Legal Medicine, College of Medicine, Post-Graduation Program in Medical Microbiology, Specialized Medical Mycology Center, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
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Brilhante RSN, Fechine MAB, Mesquita JRL, Cordeiro RA, Rocha MFG, Monteiro AJ, Lima RAC, Caetano ÉP, Pereira JF, Castelo-Branco DSCM, Camargo ZP, Sidrim JJC. Histoplasmosis in HIV-positive patients in Ceará, Brazil: clinical-laboratory aspects and in vitro antifungal susceptibility of Histoplasma capsulatum isolates. Trans R Soc Trop Med Hyg 2012; 106:484-8. [PMID: 22703696 DOI: 10.1016/j.trstmh.2012.05.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2011] [Revised: 05/15/2012] [Accepted: 05/15/2012] [Indexed: 11/28/2022] Open
Abstract
This study contains a descriptive analysis of histoplasmosis in AIDS patients between 2006 and 2010 in the state of Ceará, Brazil. Additionally, the in vitro susceptibility of Histoplasma capsulatum isolates obtained during this period was assessed. We report 208 cases of patients with histoplasmosis and AIDS, describing the epidemiological, clinical, laboratory and therapeutic aspects. The in vitro antifungal susceptibility test was carried out by the microdilution method, according to Clinical and Laboratory Standards Institute, with H. capsulatum in the filamentous and yeast phases, against the antifungals amphotericin B, fluconazole, itraconazole, voriconazole and caspofungin. In 38.9% of the cases, histoplasmosis was the first indicator of AIDS and in 85.8% of the patients the CD4 cell count was lower than 100 cells/mm(3). The lactate dehydrogenase levels were high in all the patients evaluated, with impairment of hepatic and renal function and evolution to death in 42.3% of the cases. The in vitro susceptibility profile demonstrated there was no antifungal resistance among the isolates evaluated. There was a significant increase in the number of histoplasmosis cases in HIV-positive patients during the period surveyed in the state of Ceará, northeastern Brazil, but no antifungal resistance among the recovered isolates of H. capsulatum.
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Affiliation(s)
- Raimunda S N Brilhante
- Specialized Medical Mycology Center, Federal University of Ceará, Fortaleza, Ceará, Brazil.
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Vaidya OU, Vaidya AO, Patil HR, Huseth H. Fulminant sepsis due to disseminated histoplasmosis in renal transplantation: A diagnostic challenge. J Acute Med 2012. [DOI: 10.1016/j.jacme.2012.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Identification of histoplasma-specific peptides in human urine. INTERNATIONAL JOURNAL OF PEPTIDES 2012; 2012:621329. [PMID: 22536271 PMCID: PMC3321275 DOI: 10.1155/2012/621329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 01/26/2012] [Indexed: 11/18/2022]
Abstract
Histoplasmosis is a severe dimorphic fungus infection, which is often difficult to diagnose due to similarity in symptoms to other diseases and lack of specific diagnostic tests. Urine samples from histoplasma-antigen-positive patients and appropriate controls were prepared using various sample preparation strategies including immunoenrichment, ultrafiltration, high-abundant protein depletion, deglycosylation, reverse-phase fractions, and digest using various enzymes. Samples were then analyzed by nanospray tandem mass spectrometry. Accurate mass TOF scans underwent molecular feature extraction and statistical analysis for unique disease makers, and acquired MS/MS data were searched against known human and histoplasma proteins. In human urine, some 52 peptides from 37 Histoplasma proteins were identified with high confidence. This is the first report of identification of a large number of Histoplasma-specific peptides from immunoassay-positive patient samples using tandem mass spectrometry and bioinformatics techniques. These findings may lead to novel diagnostic markers for histoplasmosis in human urine.
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Sarti ECFB, de Oliveira SMDVL, dos Santos LF, de Camargo ZP, Paniago AMM. Paracoccidioidal Infection in HIV Patients at an Endemic Area of Paracoccidioidomycosis in Brazil. Mycopathologia 2011; 173:145-9. [DOI: 10.1007/s11046-011-9495-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 10/21/2011] [Indexed: 11/30/2022]
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Braz-Silva PH, Magalhães MHCG, Hofman V, Ortega KL, Ilie MI, Odin G, Vielh P, Hofman P. Usefulness of oral cytopathology in the diagnosis of infectious diseases. Cytopathology 2010; 21:285-99. [PMID: 20629682 DOI: 10.1111/j.1365-2303.2010.00779.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In recent years, the incidence of oral opportunistic infections has increased, partly due to the widespread implementation of organ and bone marrow transplantation and the increase in the prevalence of human immunodeficiency virus (HIV) infection. Cytology can be used as a rapid, inexpensive and simple routine procedure in diagnosing infectious diseases of the mouth. Moreover, ancillary methods can be applied to cytological samples, increasing the specificity and sensitivity for the diagnosis of infectious diseases. This review describes the cytopathological features of the main viral, fungal, bacterial and parasitic infections of the mouth. Cytological techniques of specimen collection, identification of infectious agents by cytomorphological approaches and ancillary methods, and diagnostic pitfalls will be discussed.
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Affiliation(s)
- P H Braz-Silva
- Laboratory of Clinical and Experimental Pathology, Pasteur Hospital, University of Nice Sophia Antipolis, Nice, France
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Baddley JW, Sankara IR, Rodriquez JM, Pappas PG, Many WJ. Histoplasmosis in HIV-infected patients in a southern regional medical center: poor prognosis in the era of highly active antiretroviral therapy. Diagn Microbiol Infect Dis 2008; 62:151-6. [DOI: 10.1016/j.diagmicrobio.2008.05.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2008] [Revised: 05/13/2008] [Accepted: 05/22/2008] [Indexed: 10/21/2022]
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Gil-Brusola A, Pemán J, Santos M, Salavert M, Lacruz J, Gobernado M. Disseminated histoplasmosis with hemophagocytic syndrome in a patient with AIDS: description of one case and review of the Spanish literature. Rev Iberoam Micol 2008; 24:312-6. [PMID: 18095767 DOI: 10.1016/s1130-1406(07)70063-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
We report a case of disseminated histoplasmosis in a 33-year old Ecuadorian patient with AIDS and a CD4 lymphocyte count of 39 cells/microl. He presented with prolonged fever and cough, was diagnosed with hemophagocytic syndrome and multiple organ failure and died 18 days after admission. Histoplasma capsulatum was isolated post-mortem from bone marrow biopsy and blood culture. In a literature review we found 22 published cases of disseminated histoplasmosis in patients with AIDS in Spain since 1988. All but two were men under 50 years old. Nineteen had been born or had lived in endemic areas. The diagnosis of histoplasmosis was established by culture of bone marrow biopsy in 10 cases. Itraconazole was introduced as a second drug after amphotericin B in ten of the thirteen patients who survived.
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Affiliation(s)
- Ana Gil-Brusola
- Servicio de Microbiología, Hospital Universitario La Fe, Valencia, Spain.
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Marques SA, Hozumi S, Camargo RMP, Carvalho MFC, Marques MEA. Histoplasmosis presenting as cellulitis 18 years after renal transplantation. Med Mycol 2008; 46:725-8. [DOI: 10.1080/13693780802247736] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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