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Published on: February 14, 2011
Risk factor analysis of Histoplasma capsulatum fungemia
M A Assi1, M S Sandid, L M Baddour
1Division of Infectious Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. maassi@hotmail.com
Abstract:
The primary objective of the study was to investigate the risk factors for Histoplasma capsulatum fungemia. We conducted a retrospective case-control study among patients with histoplasmosis seen at Mayo Clinic in Rochester from 1 January 1991 through 31 December 2005. Blood cultures were prepared from specimens obtained from 111 patients with a diagnosis of histoplasmosis of which 55 had demonstrated H. capsulatum fungemia whereas the cultures of the remaining 56 patients were negative. The mean age of the patients was 56 years, of which 70% men and 95% were white. In univariate analysis, immunocompromised status (OR 2.9, P=0.008), peripheral leukocyte count (WBC)<3000 cells/mm(3) (OR 7.3, P<0.001), albumin<3.5 g/ dl (OR 3.1, P=0.018), and Charlson score of>4 (OR 2.9, P=0.022) were associated with H. capsulatum fungemia, but age>55 years was not (OR 1.4, P=0.38). In multivariable analysis, immunocompromised status (OR 2.4, P=0.043) and WBC<3000 cells/mm(3) (OR 6.5, P=0.001) remained significant factors associated with H. capsulatum fungemia. Immunocompromised status and WBC<3000 cells/ mm(3) are independent risk factors for the development of H. capsulatum fungemia.
Insights
Immunocompromised status and low peripheral leukocyte count (WBC) are key risk factors for Histoplasma capsulatum fungemia, a serious fungal infection. Identifying these factors aids in early detection and management of this condition.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Epidemiology
Background:
- Histoplasma capsulatum fungemia is a severe manifestation of histoplasmosis.
- Risk factors for developing H. capsulatum fungemia require further investigation for improved patient outcomes.
Purpose of the Study:
- To identify independent risk factors associated with Histoplasma capsulatum fungemia.
- To analyze patient data retrospectively to determine predictors of H. capsulatum fungemia.
Main Methods:
- A retrospective case-control study was conducted involving 111 patients diagnosed with histoplasmosis.
- Blood cultures were analyzed to identify cases of H. capsulatum fungemia (55 patients) versus controls (56 patients).
- Univariate and multivariable analyses were performed to assess risk factors including immunocompromised status, leukocyte count, albumin levels, and Charlson score.
Main Results:
- Immunocompromised status (Odds Ratio [OR] 2.4, P=0.043) and a peripheral leukocyte count (WBC) below 3000 cells/mm³ (OR 6.5, P=0.001) were significant independent risk factors for H. capsulatum fungemia.
- Univariate analysis also identified low albumin and high Charlson scores as potential risk factors.
- Age over 55 years was not found to be a significant risk factor.
Conclusions:
- Immunocompromised status and a low peripheral leukocyte count (WBC < 3000 cells/mm³) are significant independent risk factors for H. capsulatum fungemia.
- These findings highlight the importance of monitoring WBC counts in immunocompromised individuals at risk for histoplasmosis.
- Early recognition of these risk factors can guide clinical management and potentially reduce the incidence of fungemia.
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