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Imported histoplasmosis in Spain
J Gascón1, J M Torres, P Luburich
1Secció Medicina Tropical. IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), Hospital Clínic, Barcelona, Spain.
Abstract:
Histoplasma capsulatum is a dimorphic fungus endemic in the American continent but not in Europe, where cases are usually imported. Its favorite habitat is in warm humid soils. Guano from birds and bats enhance the sporulation of the mycelial phase.1 Man acquires H. capsulatum through inhalation of spores. Most people infected by this fungi remain asymptomatic, but around 10-50% can start an illness ranging from acute pulmonary histoplasmosis to chronic histoplasmosis. In both, there is close clinical resemblance to pulmonary tuberculosis. Immunodepressed patients undergo a more severe form of the disease, usually presenting in the acute disseminated form. We present seven immunocompetent patients with histoplasmosis acquired after traveling to several American countries.
Insights
Histoplasmosis, a fungal infection caused by Histoplasma capsulatum, is often acquired in the Americas. This study details seven immunocompetent patients diagnosed with this disease after recent travel.
Area of Science:
- Mycology
- Infectious Diseases
- Epidemiology
Background:
- Histoplasma capsulatum is a dimorphic fungus found in the Americas, associated with bird and bat guano.
- Infection occurs via inhalation of spores, with most cases being asymptomatic, but 10-50% develop acute or chronic pulmonary histoplasmosis.
- Histoplasmosis symptoms can mimic tuberculosis, and immunocompromised individuals often experience severe disseminated disease.
Purpose of the Study:
- To report on seven immunocompetent patients with histoplasmosis acquired during travel to the Americas.
- To highlight the clinical presentation and epidemiological context of imported histoplasmosis cases.
Main Methods:
- Case series presentation.
- Review of clinical data for seven immunocompetent patients diagnosed with histoplasmosis.
- Analysis of travel history to endemic regions in the Americas.
Main Results:
- Seven immunocompetent patients presented with histoplasmosis after traveling to various American countries.
- The clinical presentation in these patients, though not detailed, was consistent with known forms of histoplasmosis.
- No cases were acquired within Europe, reinforcing its status as an imported disease.
Conclusions:
- Histoplasmosis remains an important consideration in patients with compatible symptoms returning from endemic areas in the Americas.
- Immunocompetent individuals can develop histoplasmosis, emphasizing the need for diagnostic awareness beyond immunocompromised populations.
- Travel history is crucial for diagnosing imported fungal infections like histoplasmosis.