Related Experiment Videos
[Endemic mycotic infections]
1Fédération de médecine interne maladies infectieuses et tropicales. Hôpital Avicenne Bobigny. olivier lortholary@avc.ap-hop-paris.fr
Abstract:
AIDS epidemics and intercontinental travels in endemic areas have increased the incidence of endemic mycoses (histoplasmosis, coccidioidomycosis, blastomycosis, penicilliosis). Environmental dimorphic fungi, through an aerial contamination cause them. Frequent in the HIV patients living in endemic areas, they represent an AIDS definition criterion. Most of primary infections are asymptomatic, they may also present as influenza or pneumonia, that will spontaneously recover. A secondary dissemination may especially occur among immunocompromised hosts involving most often the skin, central nervous system and bones. Lastly, a chronic pulmonary presentation may also occur. Direct examination and histology, cultures and serologies establish diagnosis. In all cases of disseminated or chronic infections, a long-term treatment is necessary, using amphotericin B and azoles. Life-time secondary prophylaxis is recommended in AIDS patients.
Insights
Endemic mycoses, fungal infections from environmental fungi, are rising in HIV patients due to AIDS epidemics and travel. Diagnosis involves various methods, and treatment requires long-term antifungal therapy and prophylaxis.
Area of Science:
- Mycology
- Infectious Diseases
- Public Health
Background:
- AIDS epidemics and increased intercontinental travel contribute to the rising incidence of endemic mycoses.
- These fungal infections, caused by environmental dimorphic fungi, are frequent in HIV patients and can be an AIDS-defining illness.
- Primary infections are often asymptomatic or present as flu-like illness, but dissemination can occur in immunocompromised individuals.
Purpose of the Study:
- To review the epidemiology, clinical manifestations, diagnosis, and treatment of endemic mycoses in the context of HIV/AIDS.
- To highlight the significance of these infections as an AIDS-defining criterion.
Main Methods:
- Literature review of endemic mycoses (histoplasmosis, coccidioidomycosis, blastomycosis, penicilliosis) in endemic areas.
- Analysis of diagnostic methods including direct examination, histology, cultures, and serologies.
- Review of treatment strategies involving amphotericin B and azoles, and prophylaxis.
Main Results:
- Endemic mycoses are increasingly prevalent in HIV-infected individuals, particularly in endemic regions.
- Infections can disseminate to skin, CNS, and bones, or present as chronic pulmonary disease in immunocompromised hosts.
- Diagnosis relies on a combination of microbiological and serological tests.
Conclusions:
- Prompt diagnosis and long-term treatment with antifungals like amphotericin B and azoles are crucial for managing endemic mycoses in AIDS patients.
- Life-time secondary prophylaxis is recommended to prevent relapse in individuals with AIDS.