The Broad Clinical Spectrum of Disseminated Histoplasmosis in HIV-Infected Patients: A 30 Years’ Experience in French Guiana
| Autor: | Dominique Louvel, Vincent Thomas, Kinan Drak Alsibai, Magalie Demar, Pierre Couppié, Félix Djossou, Denis Blanchet, Romain Blaizot, Morgane Bourne-Watrin, Antoine Adenis, Katarina Herceg |
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| Rok vydání: | 2019 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Tuberculosis 030231 tropical medicine Direct examination Human immunodeficiency virus (HIV) Review Plant Science medicine.disease_cause Histoplasmosis 03 medical and health sciences 0302 clinical medicine Disseminated histoplasmosis Histoplasma Biosafety level parasitic diseases medicine Intensive care medicine Ecology Evolution Behavior and Systematics 0303 health sciences biology histoplasmosis 030306 microbiology business.industry HIV South America biology.organism_classification medicine.disease French Guiana histoplasma Differential diagnosis business |
| Zdroj: | Journal of Fungi |
| ISSN: | 2309-608X |
| DOI: | 10.3390/jof5040115 |
| Popis: | Histoplasmosis is a common but neglected AIDS-defining condition in endemic areas for Histoplasma capsulatum. At the advanced stage of HIV infection, the broad spectrum of clinical features may mimic other frequent opportunistic infections such as tuberculosis and makes it difficult for clinicians to diagnose histoplasmosis in a timely manner. Diagnosis of histoplasmosis is difficult and relies on a high index of clinical suspicion along with access to medical mycology facilities with the capacity to implement conventional diagnostic methods (direct examination and culture) in a biosafety level 3 laboratory as well as indirect diagnostic methods (molecular biology, antibody, and antigen detection tools in tissue and body fluids). Time to initiation of effective antifungals has an impact on the patient’s prognosis. The initiation of empirical antifungal treatment should be considered in endemic areas for Histoplasma capsulatum and HIV. Here, we report on 30 years of experience in managing HIV-associated histoplasmosis based on a synthesis of clinical findings in French Guiana with considerations regarding the difficulties in determining its differential diagnosis with other opportunistic infections. |
| Databáze: | OpenAIRE |
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