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American histoplasmosis in developing countries with a special focus on patients with HIV: diagnosis, treatment, and prognosis
- Source :
- Current Opinion in Infectious Diseases. 19:443-449
- Publication Year :
- 2006
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2006.
-
Abstract
- Histoplasmosis due to Histoplasma capsulatum var capsulatum is a frequent systemic fungal infection in the Americas. Diagnostic and therapeutic options differ between North and South America. Disseminated histoplasmosis is an AIDS-defining infection. Prognostic factors of potentially severe presentations must be evaluated in order to facilitate the initial therapeutic choice.Patients with HIV with disseminated infections presenting with severe pulmonary and renal impairment have a poor prognosis. Cutaneous presentations are more frequent in HIV patients in South America than in North America. A murine model has shown that South American isolates have a greater virulence that North American isolates. These differences are due in part to diagnostic delays in resource-poor countries.Direct examination of May-Grünwald-Giemsa-stained smears or tissues in suspected histoplasmosis is a simple means of confirming the diagnosis in resource-poor settings. Studies of prognostic factors should further refine indication criteria to guide first-line treatment choice between amphotericin B and itraconazole. The association of tuberculosis and histoplasmosis is frequent in HIV patients and presents diagnostic and therapeutic challenges that may be difficult to resolve in resource-poor settings. It is important that affordable generic drugs for treating histoplasmosis be made widely available in resource-poor countries.
- Subjects :
- Microbiology (medical)
medicine.medical_specialty
Histoplasma
HIV diagnosis
Developing country
HIV Infections
chemical and pharmacologic phenomena
complex mixtures
Histoplasmosis
fluids and secretions
Disseminated histoplasmosis
parasitic diseases
Humans
Medicine
Histoplasma capsulatum var capsulatum
biology
business.industry
South America
Prognosis
bacterial infections and mycoses
medicine.disease
biology.organism_classification
Dermatology
American histoplasmosis
Infectious Diseases
North America
Immunology
business
Subjects
Details
- ISSN :
- 09517375
- Volume :
- 19
- Database :
- OpenAIRE
- Journal :
- Current Opinion in Infectious Diseases
- Accession number :
- edsair.doi.dedup.....eb708f2da7a31c3ebc359d29d479e660