RESUMO
Micoses Sistêmicas são infecções fúngicas causadas por patógenos primários cujo trato respiratório é utilizado como porta de entrada, mas ocasionalmente se disseminam para todo o organismo. As micoses sistêmicas consideradas endêmicas no Brasil são: paracoccidioidomicose, histoplasmose, coccidioidomicose e criptococose. Por se tratarem de doenças fúngicas emergentes constata-se a necessidade de implantação de uma vigilância epidemiológica eficaz, que tenha impacto positivo na saúde pública no que diz respeito à elaboração de diretrizes e execuções de ações para prevenção, tratamento, e controle dessas micoses. Desta forma, este boletim tem como objetivo descrever o perfil de pacientes com micoses sistemas notificados em hospital de referência de Goiás. Trata-se de um estudo transversal descrito, quantitativo, com dados obtidos do Sistema de Informação de Agravos de Notificação (SINAN-NET) de um Núcleo Hospitalar de Vigilância Epidemiológica do estado de Goiás no período de 2013 a 2018
Systemic mycoses are fungal infections caused by primary pathogens whose respiratory tract is used as a gateway, but occasionally disseminate throughout the body. The systemic mycoses considered endemic in Brazil are: paracoccidioidomycosis, histoplasmosis, coccidioidomycosis and cryptococcosis. As they are emerging fungal diseases, there is a need to implement effective epidemiological surveillance, which has a positive impact on public health with regard to the elaboration of guidelines and execution of actions for the prevention, treatment, and control of these mycoses. Thus, this bulletin aims to describe the profile of patients with systemic mycoses reported in a referral hospital in Goiás. This is a descriptive, quantitative, cross-sectional study with data obtained from the Notifiable Diseases Information System (SINAN-NET) of a Hospital Center for Epidemiological Surveillance in the state of Goiás from 2013 to 2018
Assuntos
Humanos , Animais , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Paracoccidioidomicose/epidemiologia , Criptococose/epidemiologia , Histoplasmose/epidemiologia , Histoplasmose/tratamento farmacológico , Histoplasmose/transmissãoRESUMO
HISTORY AND ADMISSION FINDINGS: We report on a 57-year-old patient presenting with progressive malaise, joint pain and skin rashes one month after visiting Costa Rica. After exclusion of common tropical diseases empiric antibiotic therapy was initiated, however, the patient's symptoms did not improve. INVESTIGATIONS: CT scan of the chest demonstrated an intrapulmonary nodular lesion. Bronchoscopy revealed no pathological changes. Microbiologic analysis of the bronchoalveolar lavage fluids identified no pathogen. An abdominal ultrasound examination did not reveal pathological findings. Serological tests were positive for Histoplasma capsulatum. TREATMENT AND COURSE: Treatment with itraconazole resulted in a fast initial clinical improvement, but complete resolution of all symptoms only occurred after completion of a 6-months course of itraconazole. Serial CT scans demonstrated a continuous regression of the pulmonary lesion. CONCLUSION: Histoplasmosis has a low incidence among travelers. However, histoplasmosis should be considered in patients with respiratory symptoms and history of travel to endemic countries, specifically when common traveler diseases have been excluded. Diagnosis is confirmed by serology, imaging and ultimately by biopsy for histological, cultural and molecular identification of the pathogen. Antimycotic drug therapy is the recommended treatment of choice for symptomatic cases.
Assuntos
Artralgia/etiologia , Países em Desenvolvimento , Fadiga/etiologia , Histoplasma , Histoplasmose/diagnóstico , Pneumopatias Fúngicas/diagnóstico , Viagem , Animais , Quirópteros/microbiologia , Costa Rica , Diagnóstico Diferencial , Histoplasmose/transmissão , Humanos , Pneumopatias Fúngicas/transmissão , Masculino , Pessoa de Meia-IdadeRESUMO
Exploring caves is, without doubt, a very exciting adventure; however, it carries some dangers. Three of four travellers were admitted to hospital with lung changes after returning from Ecuador, successively. Epidemiological studies revealed that the travellers visited caves infested by bats, and had contact with bats' guano. They gave a history of fever, fatigue, myalgia, dry cough, and chest pain during the stay or just after returning from Ecuador. In two patients, symptoms persisted in mild nature. Chest X-ray films showed diffuse nodules (coin-like lesions) in the lungs in each case. Histoplasmosis was taken into consideration. Differential diagnosis included paragonimiasis, pulmonary tuberculosis, and pulmonary infection of other causes. Direct examination of sputum was negative. Cultures were negative. Final diagnosis was made on epidemiological histories, as well as typical radiological changes, and was supported by positive tests for antibodies to Histoplasma capsulatum. Immunodiffusion test (ID), complement fixation test (CFTs), and Western blot test were positive. In two cases antifungal treatment was established. Ketoconazole followed by Itraconazole were used. Persons who are going to explore caves should be equipped with anti-dusk masks to prevent pulmonary histoplasmosis. The threat of Histoplasma capsulatum infection in bat-inhabited caves should be emphasized to travellers and also to physicians.
Assuntos
Cavernas/parasitologia , Histoplasma/isolamento & purificação , Histoplasmose/epidemiologia , Pneumopatias/epidemiologia , Medicina de Viagem/estatística & dados numéricos , Viagem/estatística & dados numéricos , Adulto , Animais , Quirópteros , Surtos de Doenças , Equador/epidemiologia , Feminino , Histoplasmose/diagnóstico , Histoplasmose/transmissão , Humanos , Pneumopatias/diagnóstico , Pneumopatias/diagnóstico por imagem , Masculino , Polônia/epidemiologia , Radiografia , Adulto JovemAssuntos
Histoplasmose/diagnóstico por imagem , Pneumopatias Fúngicas/diagnóstico por imagem , Doença Aguda , Animais , Biópsia , Quirópteros/microbiologia , Exposição Ambiental , Fezes/microbiologia , Histoplasmose/diagnóstico , Histoplasmose/patologia , Histoplasmose/transmissão , Humanos , Pulmão/microbiologia , Pulmão/patologia , Pneumopatias Fúngicas/diagnóstico , Pneumopatias Fúngicas/microbiologia , Pneumopatias Fúngicas/patologia , Pneumopatias Fúngicas/transmissão , Masculino , Radiografia , Coloração pela Prata , Adulto JovemRESUMO
Se describe un brote de histoplasmosis que afectó a 6 cadetes de la Fuerza Aérea Argentina, sin antecedentes patológicos previos. Todos consultaron por problemas respiratorios después de haber limpiado un hangar. En ese recinto se encontraron abundantes deyecciones de animales, presuntamente de palomas y murciélagos. Los pacientes sufrieron fiebre, mialgias, taquipnea y tos no productiva. Las radiografías y tomografías de tórax mostraron imágenes pulmonares micronodulares, engrosamiento de los tabiques interalveolares y adenopatías hiliares. Todos tuvieron una evolución favorable y no requirieron tratamiento antifúngico. Las pruebas de inmunodifusión y contrainmunoelectroforesis con antígenos de Histoplasma capsulatum fueron positivas, al igual que las intradermorreacciones con histoplasmina. Se recogieron 5 muestras de tierra del lugar, las que fueron inoculadas por vía intraperitoneal a 20 hámsteres. De los cultivos de hígado y bazo de dichos animales se consiguió aislar la fase micelial de H. capsulatum. La cepa aislada se comparó con las obtenidas de 12 pacientes argentinos utilizando perfiles genéticos y se observó un clado único con más de 96% de similitud, lo que confirma la homogeneidad de las cepas argentinas. Si bien la histoplasmosis es endémica en la Pampa húmeda, este es el primer brote totalmente documentado al sur del paralelo 34°.
An histoplasmosis outbreak affecting 6 previously healthy Air Force cadets is herein presented. The patients suffered from fever and respiratory symptoms after having cleaned an abandoned hangar soiled with pigeons and bat droppings. They all presented fever, myalgia, tachypnea, and nonproductive cough. Chest X-ray and CT scan studies showed disseminated reticulonodular images affecting both lungs. Hiliar adenomegalies were also observed. All patients achieved a favourable outcome without antifungal treatment. Both serologic tests searching for specificic antibodies (immunodiffusion and counterimmunoelectrophoresis) and histoplasmin skin tests were positive in all cases. Five soil samples mixed with pigeons and bat droppings were collected from the hangar. Suspensions of these samples were inoculated into 20 hamsters by intraperitoneal injection; mycelial phase of H. capsulatum was isolated from liver and spleen cultures. The genetic profile of this strain was compared with 12 isolates obtained from Argentinean patients, and a great degree of homogeneity was observed (> 96% similarity). Although histoplasmosis is endemic in the wet Pampas, this is the first epidemic outbreak reported south of the 34th parallel.
Assuntos
Adulto , Animais , Cricetinae , Humanos , Masculino , Adulto Jovem , Surtos de Doenças , Histoplasmose/epidemiologia , Militares , Argentina/epidemiologia , Quirópteros/microbiologia , Columbidae/microbiologia , DNA Fúngico/análise , Plumas/microbiologia , Fezes/microbiologia , Histoplasma/classificação , Histoplasma/genética , Histoplasma/crescimento & desenvolvimento , Histoplasma/isolamento & purificação , Histoplasmina , Histoplasmose/diagnóstico , Histoplasmose/transmissão , Mesocricetus , Exposição Ocupacional , Testes CutâneosRESUMO
A histoplasmosis outbreak affecting 6 previously healthy Air Force cadets is herein presented. The patients suffered from fever and respiratory symptoms after having cleaned an abandoned hangar soiled with pigeons and bat droppings. They all presented fever, myalgia, tachypnea, and nonproductive cough. Chest X-ray and CT scan studies showed disseminated reticulonodular images affecting both lungs. Hiliar adenomegalies were also observed. All patients achieved a favourable outcome without antifungal treatment. Both serologic tests searching for specificic antibodies (immunodiffusion and counterimmunoelectrophoresis) and histoplasmin skin tests were positive in all cases. Five soil samples mixed with pigeons and bat droppings were collected from the hangar. Suspensions of these samples were inoculated into 20 hamsters by intraperitoneal injection; mycelial phase of H. capsulatum was isolated from liver and spleen cultures. The genetic profile of this strain was compared with 12 isolates obtained from Argentinean patients, and a great degree of homogeneity was observed (> 96% similarity). Although histoplasmosis is endemic in the wet Pampas, this is the first epidemic outbreak reported south of the 34th parallel.
Assuntos
Surtos de Doenças , Histoplasmose/epidemiologia , Militares , Adulto , Animais , Argentina/epidemiologia , Quirópteros/microbiologia , Columbidae/microbiologia , Cricetinae , DNA Fúngico/análise , Plumas/microbiologia , Fezes/microbiologia , Histoplasma/classificação , Histoplasma/genética , Histoplasma/crescimento & desenvolvimento , Histoplasma/isolamento & purificação , Histoplasmina , Histoplasmose/diagnóstico , Histoplasmose/transmissão , Humanos , Masculino , Mesocricetus , Exposição Ocupacional , Testes Cutâneos , Adulto JovemRESUMO
Our observation of histoplasmosis cases augments the current knowledge on transmission by bats. In the presented cases, the only contact happened in the proximity of a bat cave but not inside the cave. We wish to communicate and stress that even outside of caves, bats may disperse the organism.
Assuntos
Histoplasmose/diagnóstico , Exposição por Inalação , Pneumopatias Fúngicas/diagnóstico , Viagem , Adulto , Animais , Antibacterianos/uso terapêutico , Quirópteros , Reservatórios de Doenças , Vetores de Doenças , Alemanha , Histoplasma/isolamento & purificação , Histoplasmose/tratamento farmacológico , Histoplasmose/microbiologia , Histoplasmose/transmissão , Humanos , Pneumopatias Fúngicas/tratamento farmacológico , Pneumopatias Fúngicas/microbiologia , Pneumopatias Fúngicas/transmissão , Masculino , Resultado do Tratamento , Trinidad e TobagoRESUMO
OBJECTIVE: Evaluation of the usefulness of a quantitative real-time polymerase chain reaction-based (RT-PCR) technique for clinical diagnosis of histoplasmosis. METHODS: Primers and probes were designed on the basis of sequences from the ITS regions of ribosomal DNA of 20 clinical strains of Histoplasma capsulatum. LightCycler procedures (Roche Applied Science) were used with probes marked by fluorescence resonance energy transfer (FRET). Reproducibility, sensitivity, and specificity were analyzed. In addition, an internal control was designed to identify false negative results by PCR inhibition. The RT-PCR assay was tested in 22 clinical samples from 14 patients with proven histoplasmosis. In addition, 30 samples from patients with febrile neutropenia or mycoses other than histoplasmosis, and from healthy volunteers were analyzed as controls. RESULTS: The limit of detection of the assay was 1 fg of genomic DNA per microl of sample. The PCR-based technique was reproducible and highly specific. Positive results were obtained in 11/14 (78.6%) patients and in 17/22 (77.3%) clinical samples. RT-PCR was positive in 100% of respiratory secretions and bone marrow samples, but only 70% of sera (p < 0.01). Mean fungal DNA value was 23.1 fg/microl in serum and 4.85 x 10(3) fg/microl in respiratory and bone marrow samples. RT-PCR results were positive in serum from three HIV patients for which antibody detection by immunodiffusion was negative. Specificity was 100%, since PCR results were negative for all the control samples. CONCLUSION: Thes RT-PCR technique is a sensitive, specific method for early diagnosis of histoplasmosis, particularly when respiratory secretions or bone marrow samples are analyzed. The reliability is lower in serum, but it can be used as an additional, complementary technique to culture and serology in HIV patients.
Assuntos
DNA Fúngico/isolamento & purificação , DNA Ribossômico/isolamento & purificação , Histoplasma/isolamento & purificação , Histoplasmose/diagnóstico , Reação em Cadeia da Polimerase/métodos , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico , Infecções Oportunistas Relacionadas com a AIDS/microbiologia , África/etnologia , Líquidos Corporais/microbiologia , Medula Óssea/microbiologia , América Central/etnologia , Sistemas Computacionais , DNA Fúngico/genética , DNA Ribossômico/genética , Emigração e Imigração , Infecções por HIV/complicações , Histoplasma/genética , Histoplasmose/complicações , Histoplasmose/epidemiologia , Histoplasmose/microbiologia , Histoplasmose/transmissão , Imunodifusão , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , América do Sul/etnologia , Espanha/epidemiologia , ViagemAssuntos
Histoplasmose/diagnóstico , Pneumopatias Fúngicas/diagnóstico , Adulto , Animais , Animais Selvagens/microbiologia , Argentina , Columbidae/microbiologia , Diagnóstico Diferencial , Fezes/microbiologia , Hepatomegalia/etiologia , Histoplasmina/imunologia , Histoplasmose/complicações , Histoplasmose/diagnóstico por imagem , Histoplasmose/patologia , Histoplasmose/transmissão , Humanos , Hipergamaglobulinemia/etiologia , Imunodifusão , Testes Intradérmicos , Pneumopatias Fúngicas/complicações , Pneumopatias Fúngicas/diagnóstico por imagem , Pneumopatias Fúngicas/patologia , Pneumopatias Fúngicas/transmissão , Masculino , Ratos/microbiologia , Esplenomegalia/etiologia , Tomografia Computadorizada por Raios XRESUMO
We report the first isolation of Histoplasma capsulatum var. capsulatum from a male bat Eumops bonariensis captured in Buenos Aires city in 2003. The pathogen was recovered from spleen and liver specimens, and was identified by its phenotypic characteristics. PCR with primers 1283, (GTG)5, (GACA)4 and M13 was used to compare both bat isolates with 17 human isolates, 12 from patients residing in Buenos Aires city, and 5 from other countries of the Americas. The profiles obtained with the four primers showed that both bat isolates were identical to each other and closer to Buenos Aires patients than to the other isolates (similarity percentage: 91-100% and 55-97%, respectively). The high genetic relationship between bat isolates and those from patients living in Buenos Aires suggests a common source of infection. This is the first record of E. bonariensis infected with H. capsulatum in the world, and the first isolation of the fungus in the Argentinean Chiroptera population. In the same way as these wild mammals act as reservoir and spread the fungus in the natural environment, infection in urban bats could well be associated with the increase in histoplasmosis clinical cases among immunosuppressed hosts in Buenos Aires city.
Assuntos
Quirópteros/microbiologia , Histoplasma/isolamento & purificação , América , Animais , Argentina/epidemiologia , Quirópteros/classificação , DNA Fúngico/genética , Reservatórios de Doenças , Histoplasma/genética , Histoplasmose/epidemiologia , Histoplasmose/microbiologia , Histoplasmose/transmissão , Humanos , Hospedeiro Imunocomprometido , Fígado/microbiologia , Masculino , Infecções Oportunistas/epidemiologia , Infecções Oportunistas/microbiologia , Infecções Oportunistas/transmissão , Especificidade da Espécie , Baço/microbiologia , Saúde da População UrbanaRESUMO
Se comunica el primer aislamiento de Histoplasma capsulatum var. capsulatum de un murciélago macho de la especie Eumops bonariensis, capturado en la ciudad de Buenos Aires en 2003. Los aislamientos fueron recuperados de bazo e hígado e identificados fenotípicamente. Se los comparó por PCR, con 17 aislamientos clínicos, 12 de pacientes residentes en la ciudad de Buenos Aires y cinco de otros países de América, usando los iniciadores 1283, (GTG)5, (GACA)4 y M13. Con los cuatro iniciadores, los perfiles de los aislamientos de murciélago resultaron idénticos entre sí y más relacionados a los de pacientes de Buenos Aires que a los de otros países (porcentaje de similitud: 91-100% y 55-87%, respectivamente). La alta relación genética entre los aislamientos obtenidos del murciélago y de los humanos residentes en Buenos Aires sugiere una fuente común de infección. Este es el primer registro de E. bonariensis infectado con H. capsulatum en el mundo, y el primer aislamiento del hongo en la población de quirópteros de la Argentina. Así como estos mamíferos actúan como reservorio y dispersan el hongo en la naturaleza, la infección en murciélagos urbanos podría asociarse al elevado número de casos de histoplasmosis entre pacientes inmunodeprimidos en la ciudad de Buenos Aires.
We report the first isolation of Histoplasma capsulatum var. capsulatum from a male bat Eumops bonariensis captured in Buenos Aires city in 2003. The pathogen was recovered from spleen and liver specimens, and was identified by its phenotypic characteristics. PCR with primers 1283, (GTG)5, (GACA)4 and M13 was used to compare both bat isolates with 17 human isolates, 12 from patients residing in Buenos Aires city, and 5 from other countries of the Americas. The profiles obtained with the four primers showed that both bat isolates were identical to each other and closer to Buenos Aires patients than to the other isolates (similarity percentage: 91-100% and 55-97%, respectively). The high genetic relationship between bat isolates and those from patients living in Buenos Aires suggests a common source of infection. This is the first record of E. bonariensis infected with H. capsulatum in the world, and the first isolation of the fungus in the Argentinean Chiroptera population. In the same way as these wild mammals act as reservoir and spread the fungus in the natural environment, infection in urban bats could well be associated with the increase in histoplasmosis clinical cases among immunosuppressed hosts in Buenos Aires city.
Assuntos
Animais , Humanos , Masculino , Quirópteros/microbiologia , Histoplasma/isolamento & purificação , América , Argentina/epidemiologia , Quirópteros/classificação , Reservatórios de Doenças , DNA Fúngico/genética , Histoplasma/genética , Histoplasmose/epidemiologia , Histoplasmose/microbiologia , Histoplasmose/transmissão , Hospedeiro Imunocomprometido , Fígado/microbiologia , Infecções Oportunistas/epidemiologia , Infecções Oportunistas/microbiologia , Infecções Oportunistas/transmissão , Especificidade da Espécie , Baço/microbiologia , Saúde da População UrbanaRESUMO
CASE HISTORY: Four males (age 25 to 40 years) and one female (age 25) were admitted to our hospital almost simultaneously with symptoms of fever up to 38 degrees C, dry cough, thoracodynia, dyspnoea, myalgia and arthralgia. All patients belonged to a team of eight German bat researchers who had returned from Cuba 10 days before, where they had investigated bats in caves. Another member of the team had only mild histoplasmosis and was followed in our outpatient clinic. Two scientists who wore their breathing masks continuously during their work in the caves did not fall ill. EXAMINATIONS: Chest X-rays of all in-patients showed pulmonary infiltrates correlating with the severity of their illness. In all patients specific IgG antibodies against Histoplasma capsulatum-antigen were found in the Western Blot assay, confirming the diagnosis of histoplasmosis. TREATMENT: Treatment with oral itraconazole 200 mg b.d was given to four inpatients for 6 weeks, in the fifth patient itraconazole was discontinued because of an increase of liver transaminases. CONCLUSION: Antimycotic treatment of advancing histoplasmosis seems appropriate also in immunocompetent patients. The high number of patients within this group suggests high numbers of Histoplasma capsulatum in the caves. Wearing breathing masks throughout the work in the caves may prevent histoplasmosis even in case of high infectious doses. Pre-travel recommendations for cave researchers have to emphasize the continuous use of breathing masks and vaccination against tetanus and rabies.
Assuntos
Quirópteros/microbiologia , Histoplasmose/transmissão , Pneumopatias Fúngicas/transmissão , Viagem , Adulto , Animais , Cuba , Diagnóstico Diferencial , Feminino , Histoplasmose/diagnóstico , Humanos , Pneumopatias Fúngicas/diagnóstico , Masculino , PesquisaRESUMO
On March 30, CDC was notified by the Pennsylvania Department of Health of an acute febrile respiratory illness characterized by fever, chills, dry cough, chest pain, and headache among college students who traveled to Acapulco during March 2001. Initial laboratory testing indicated that most students had histoplasmosis, an infection caused by the soil-inhabiting fungus, Histoplasma capsulatum. While in Acapulco, most ill students had stayed at the Calinda Beach Hotel. This report updates the investigation of the outbreak and presents possible evidence of ongoing transmissions.
Assuntos
Surtos de Doenças , Histoplasmose/epidemiologia , Histoplasmose/transmissão , Infecções/epidemiologia , Infecções/transmissão , Viagem , Adulto , Estudos de Coortes , Feminino , Febre/etiologia , Histoplasma , Histoplasmose/diagnóstico , Habitação , Humanos , Infecções/diagnóstico , Infecções/microbiologia , Masculino , México/epidemiologia , Sistema Respiratório , Estudantes , Estados Unidos/epidemiologiaAssuntos
Surtos de Doenças , Histoplasmose/epidemiologia , Histoplasmose/transmissão , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/transmissão , Viagem , Adulto , Estudos de Coortes , Feminino , Febre/etiologia , Histoplasma , Histoplasmose/diagnóstico , Habitação , Humanos , Masculino , México/epidemiologia , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/microbiologia , Estudantes , Estados Unidos/epidemiologiaRESUMO
This report describes the clinical and epidemiological findings of an outbreak of histoplasmosis in Brazil involving four persons of the same family, one adult and three children. Contamination by fecal material of bats in the basement of the house was found to be the most likely cause of this outbreak. None of the patients had evidence of immune deficiency. The adult died of acute respiratory distress syndrome. A more severe presentation of the disease in this patient may be partly explained by a heavier exposure to the feces of bats.
Assuntos
Quirópteros/microbiologia , Fezes/microbiologia , Histoplasmose/complicações , Síndrome do Desconforto Respiratório/etiologia , Adulto , Animais , Criança , Pré-Escolar , Surtos de Doenças , Feminino , Histoplasmose/transmissão , Humanos , MasculinoRESUMO
Introducción: La histoplasmosis pulmonar primaria (HPP) en México debería ser considerada un problema de salud pública, no sólo por su magnitud sino por su trascendencia, dada por la gravedad del cuadro clínico y por la elevada tasa de mortalidad. Con respecto a sus implicaciones económicas, su alta incidencia en trabajadores mineros obstaculiza la reexplotación de muchas minas que aún contienen ricas vetas minerales. características de la HPP en México: La gravedad de la HPP se debe especialmente a la gran carga de hongo inhalada en medios ambientes cerrados como cavernas, túneles y pozos, además de viejas minas y construcciones abandonadas que contienen gran cantidad de guano de murciélagos. Otro factor importante asociado a la HPP, lo constituye la aparente alta virulencia de las cepas de Histoplasma capsulatum aisladas en el país. En este artículo, se citan ejemplos y comparaciones entre la gravedad de los cuadros clínicos de los brotes epidémicos mexicanos y estadounidenses. Adicionalmente, se comenta la recuperación rápida de pacientes tratados con anfotericina B liposomal a diferencia del tratamiento con la anfotericina B tradicional
Assuntos
Humanos , Histoplasma , Histoplasmose/epidemiologia , Histoplasmose/terapia , Histoplasmose/transmissão , Histoplasmose/virologia , Pneumopatias Fúngicas/epidemiologia , Pneumopatias Fúngicas/etiologia , Pneumopatias Fúngicas/terapia , Pneumopatias Fúngicas/transmissão , México/epidemiologiaRESUMO
O autor apresenta uma revisão crítica sobre aspectos epidemiológicos da histoplasmose no Rio Grande do Sul. Alerta para o risco da doença disseminada em pacientes imunodeprimidos, especialmente com HIV, como infecção oportunística
Assuntos
Humanos , Histoplasmose/epidemiologia , Histoplasmose/diagnóstico , Histoplasmose/tratamento farmacológico , Histoplasmose/transmissão , Infecções Oportunistas Relacionadas com a AIDSRESUMO
La histoplasmosis es una micosis endémica en todos los continentes excepto en la Antártida, causado por el hongo dimórfico Histoplasma capsulatum, var. capsulatum. La infección pulmonar primaria generalmente es asintomática, o una enfermedad febril, autolimitada. Se han reconocido tres categorías diferentes: pulmonar aguda, pulmonar crónica y diseminada progresiva, con ataque al sistema fagocítrico. Las pruebas serológicas, los cultivos del hongo y la histopatología son útiles para establecer el diagnóstico. Los tejidos deben ser teñidos con plata para visualizar las levaduras. El sistema del hemocultivo de lisiscentrifugación, puede detectar al H. capsulatum de una a dos semanas. Existe un procedimiento para la detección del antígeno, muy útil para el seguimiento de la terapia, incluyendo a los pacientes infectados por el virus de la inmunodeficiencia humana (VIH). La terapia antifúngica no está indicada en la mayoría de los enfermos, aunque algunos tienen una enfermedad prolongada (> 3 semanas). El diagnóstico temprano y un tratamiento oportuno con enfotericina B o itraconazol, puede acelerar la resolución de la enfermedad. El flunconazol es una elección razonable en la terapia supresiva crónica
Assuntos
Humanos , Anfotericina B/uso terapêutico , Técnicas de Laboratório Clínico , Histoplasma/citologia , Histoplasma/patogenicidade , Histoplasmose/diagnóstico , Histoplasmose/epidemiologia , Histoplasmose/etiologia , Histoplasmose/história , Histoplasmose/fisiopatologia , Histoplasmose/transmissãoRESUMO
Se presenta el caso de una paciente con histoplasmosis ganglionar, cuyo diagnóstico se efectuó a partir de antecedentes epidemiológicos, pruebas serológicas y estudio histopatológico de ganglios afectos. Se reseñan los aspectos clínicos, el diagnóstico y el tratamiento aplicado a esta enferma. Se revisa el tema y se comparan los resultados con los de otros autores