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Volume 13, Number 11—November 2007

Literature Review and Case Histories of Histoplasma capsulatum var. duboisii Infections in HIV-infected Patients

Pierre Loulergue*†, Frédéric Bastides‡, Véronique Baudouin§, Jacques Chandenier‡, Patricia Mariani-Kurkdjian§, Bertrand Dupont*†, Jean-Paul Viard*†, Françoise Dromer¶, and Olivier Lortholary†¶Comments to Author 
Author affiliations: *University Paris V, Paris, France; †Hôpital Necker-Enfants Malades, Paris, France; ‡Centre Hospitalier Universitaire Bretonneau, Tours, France; §Hôpital Robert Debré, Paris, France; ¶Institut Pasteur, Paris, France;

Main Article

Table 2

Comparison of clinical and microbiologic findings of HIV-infected and immunocompetent patients with histoplasmosis due to variety duboisii*†

Characteristic HIV positive (n = 17) HIV negative (n = 20)
Age, y (range) 35 (2–65) 34 (8–62)
Sex (M:F)
Visceral localizations
Lymph nodes 53 65
Skin 59 40
Bones 18 25
Lungs 0† 35†
Gastrointestinal 12 5
Clinical manifestations
Fever 58† 15†
Weight loss, asthenia, anorexia 54 30
Respiratory symptoms 0 20
Diagnosis sites
Lymph nodes 24 45
Skin 48 35
Bone marrow 18 0
Bone 12 5
Gastrointestinal 6 5
Pus 6 25
Mycologic diagnosis
Direct examination 100 40
Culture 64 65
Blood culture
Amphotericin B 66 80
Ketoconazole 12 35
Itraconazole 64 20
Relapse 12 40
Death 24 5

*Except where indicated, all values are percentages. HIV-negative patients are from Dupont et al. (13).

Main Article

  1. Wheat  LJ, Kauffman  CA. Histoplasmosis. [vii.]. Infect Dis Clin North Am. 2003;17:119. DOIPubMedGoogle Scholar
  2. Wheat  LJ. Histoplasmosis: a review for clinicians from non-endemic areas. Mycoses. 2006;49:27482. DOIPubMedGoogle Scholar
  3. Manfredi  R, Mazzoni  A, Nanetti  A, Chiodo  F. Histoplasmosis capsulati and duboisii in Europe: the impact of the HIV pandemic, travel and immigration. Eur J Epidemiol. 1994;10:67581. DOIPubMedGoogle Scholar
  4. McKinsey  DS, Spiegel  RA, Hutwagner  L, Stanford  J, Driks  MR, Brewer  J, Prospective study of histoplasmosis in patients infected with human immunodeficiency virus: incidence, risk factors, and pathophysiology. Clin Infect Dis. 1997;24:1195203. DOIPubMedGoogle Scholar
  5. Carme  B, Ngolet  A, Ebikili  B, Ngaporo  AI. Is African histoplasmosis an opportunistic fungal infection in AIDS? Trans R Soc Trop Med Hyg. 1990;84:293. DOIPubMedGoogle Scholar
  6. Breton  G, Adle-Biassette  H, Therby  A, Ramanoelina  J, Choudat  L, Bissuel  F, Immune reconstitution inflammatory syndrome in HIV-infected patients with disseminated histoplasmosis. AIDS. 2006;20:11921. DOIPubMedGoogle Scholar
  7. Gugnani  HC, Muotoe-Okafor  F. African histoplasmosis: a review. Rev Iberoam Micol. 1997;14:1559.PubMedGoogle Scholar
  8. Wheat  LJ, Connolly-Stringfield  PA, Baker  RL, Curfman  MF, Eads  ME, Israel  KS, Disseminated histoplasmosis in the acquired immune deficiency syndrome: clinical findings, diagnosis and treatment, and review of the literature. Medicine (Baltimore). 1990;69:36174.PubMedGoogle Scholar
  9. Dromer  F, Mathoulin-Pelissier  S, Launay  O, Lortholary  O. Determinants of disease presentation and outcome during Cryptococcosis: the CryptoA/D study. PLoS Med. 2007;4:e21. DOIPubMedGoogle Scholar
  10. Gugnani  HC, Egere  JU, Larsh  H. Skin sensitivity to capsulatum and duboisii histoplasmins in Nigeria. J Trop Med Hyg. 1991;94:246.PubMedGoogle Scholar
  11. Muotoe-Okafor  FA, Gugnani  HC, Gugnani  A. Skin and serum reactivity among humans to histoplasmin in the vicinity of a natural focus of Histoplasma capsulatum var. duboisii. Mycopathologia. 1996;134:714. DOIPubMedGoogle Scholar
  12. Thompson  GR III, LaValle  CE III, Everett  ED. Unusual manifestations of histoplasmosis. Diagn Microbiol Infect Dis. 2004;50:3341. DOIPubMedGoogle Scholar
  13. Dupont  B, Lortholary  O, Datry  A, Gentilini  M, Vinchon  I, Guillevin  L. Imported histoplasmosis due to H. duboisii in France (1968–1994). 36th Interscience Conference on Antimicrobial Agents and Chemotherapy; New Orleans, LA; 1996 Sept 15–18. Abstract K58.
  14. Minta  DK, Dembele  M, Lorre  G, Diallo  DA, Traore  HA, Chabasse  D. African histoplasmosis (Histoplasma capsulatum var. duboisii): a case report from Mali [in French]. Sante. 2005;15:1959.PubMedGoogle Scholar
  15. Geffray  L, Veyssier  P, Cevallos  R, Beaud  B, Mayolle  J, Nogier  C, African histoplasmosis: clinical and therapeutic aspects, relation to AIDS. Apropos of 4 cases, including a case with HIV-1-HTLV-1 co-infection [in French]. Ann Med Interne (Paris). 1994;145:4248.PubMedGoogle Scholar
  16. Murata  M, Furusyo  N, Otaguro  S, Nabeshima  S, Ariyama  I, Hayashi  J. HIV infection with concomitant cerebral toxoplasmosis and disseminated histoplasmosis in a 45-year-old man. J Infect Chemother. 2007;13:515. DOIPubMedGoogle Scholar
  17. Carme  B, Ngaporo  AI, Ngolet  A, Ibara  JR, Ebikili  B. Disseminated African histoplasmosis in a Congolese patient with AIDS. J Med Vet Mycol. 1992;30:2458. DOIPubMedGoogle Scholar
  18. Chandenier  J, Goma  D, Moyen  G, Samba-Lefebvre  MC, Nzingoula  S, Obengui, et al. African histoplasmosis due to Histoplasma capsulatum var. duboisii: relationship with AIDS in recent Congolese cases [in French]. Sante. 1995;5:22734.PubMedGoogle Scholar
  19. Antinori  S, Magni  C, Nebuloni  M, Parravicini  C, Corbellino  M, Sollima  S, Histoplasmosis among human immunodeficiency virus-infected people in Europe: report of 4 cases and review of the literature. Medicine (Baltimore). 2006;85:2236. DOIPubMedGoogle Scholar
  20. Sharmin  S, Ohori  A, Sano  A, Kamei  K, Yamaguchi  M, Takeo  K, Histoplasma capsulatum variety duboisii isolated in Japan from an HIV-infected Ugandan patient. Nippon Ishinkin Gakkai Zasshi. 2003;44:299306.PubMedGoogle Scholar
  21. Tobon  AM, Agudelo  CA, Rosero  DS, Ochoa  JE, De Bedout  C, Zuluaga  A, Disseminated histoplasmosis: a comparative study between patients with acquired immunodeficiency syndrome and non-human immunodeficiency virus-infected individuals. Am J Trop Med Hyg. 2005;73:57682.PubMedGoogle Scholar
  22. Klassen-Fischer  M, McEvoy  P, Neafie  RC, Nelson  AM. Accurate diagnosis of infection with Histoplasma capsulatum var. duboisii. Clin Infect Dis. 2004;38:595, author reply 596. DOIPubMedGoogle Scholar
  23. Wheat  LJ, Connolly-Stringfield  P, Blair  R, Connolly  K, Garringer  T, Katz  BP, Effect of successful treatment with amphotericin B on Histoplasma capsulatum variety capsulatum polysaccharide antigen levels in patients with AIDS and histoplasmosis. Am J Med. 1992;92:15360. DOIPubMedGoogle Scholar
  24. Wheat  LJ, Connolly-Stringfield  P, Blair  R, Connolly  K, Garringer  T, Katz  BP. Histoplasmosis relapse in patients with AIDS: detection using Histoplasma capsulatum variety capsulatum antigen levels. Ann Intern Med. 1991;115:93641.PubMedGoogle Scholar
  25. Kauffman  CA. Histoplasmosis: a clinical and laboratory update. Clin Microbiol Rev. 2007;20:11532. DOIPubMedGoogle Scholar
  26. Maubon  D, Simon  S, Aznar  C. Histoplasmosis diagnosis using a polymerase chain reaction method. Application on human samples in French Guiana, South America. Diagn Microbiol Infect Dis. 2007;58:4414. Epub 2007 May 16. DOIPubMedGoogle Scholar
  27. Rickerts  V, Bialek  R, Tintelnot  K, Jacobi  V, Just-Nubling  G. Rapid PCR-based diagnosis of disseminated histoplasmosis in an AIDS patient. Eur J Clin Microbiol Infect Dis. 2002;21:8213. DOIPubMedGoogle Scholar
  28. Bracca  A, Tosello  ME, Girardini  JE, Amigot  SL, Gomez  C, Serra  E. Molecular detection of Histoplasma capsulatum var. capsulatum in human clinical samples. J Clin Microbiol. 2003;41:17535. DOIPubMedGoogle Scholar
  29. Wheat  J, Sarosi  G, McKinsey  D, Hamill  R, Bradsher  R, Johnson  P, Practice guidelines for the management of patients with histoplasmosis. Infectious Diseases Society of America. Clin Infect Dis. 2000;30:68895. DOIPubMedGoogle Scholar
  30. Wheat  LJ, Connolly  P, Smedema  M, Brizendine  E, Hafner  R. Emergence of resistance to fluconazole as a cause of failure during treatment of histoplasmosis in patients with acquired immunodeficiency disease syndrome. Clin Infect Dis. 2001;33:19103. DOIPubMedGoogle Scholar
  31. Wheat  LJ, Connolly  P, Smedema  M, Durkin  M, Brizendine  E, Mann  P, Activity of newer triazoles against Histoplasma capsulatum from patients with AIDS who failed fluconazole. J Antimicrob Chemother. 2006;57:12359. DOIPubMedGoogle Scholar
  32. Lortholary  O, Denning  DW, Dupont  B. Endemic mycoses: a treatment update. J Antimicrob Chemother. 1999;43:32131. DOIPubMedGoogle Scholar
  33. Goldman  M, Zackin  R, Fichtenbaum  CJ, Skiest  DJ, Koletar  SL, Hafner  R, Safety of discontinuation of maintenance therapy for disseminated histoplasmosis after immunologic response to antiretroviral therapy. Clin Infect Dis. 2004;38:14859. DOIPubMedGoogle Scholar
  34. Shelburne  SA III, Hamill  RJ. The immune reconstitution inflammatory syndrome. AIDS Rev. 2003;5:6779.PubMedGoogle Scholar

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