[Disseminated histoplasmosis in patients with AIDS. Buenos Aires, 2009-2014]

Area of Science:

• Infectious Diseases
• Mycology
• Immunology

Background:

• Disseminated histoplasmosis is a severe opportunistic infection in individuals with advanced Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS).
• The epidemiology of histoplasmosis in HIV/AIDS patients can fluctuate, necessitating ongoing surveillance and awareness within the medical community.

Purpose of the Study:

• To analyze the clinical characteristics, diagnostic methods, treatment, and outcomes of disseminated histoplasmosis in HIV/AIDS patients.
• To identify trends in histoplasmosis incidence among HIV/AIDS patients over a defined period.

Main Methods:

• Retrospective analysis of 171 HIV/AIDS patients diagnosed with disseminated histoplasmosis between 2009 and 2014.
• Review of patient demographics, clinical presentations (cutaneous, respiratory), diagnostic test results (Giemsa staining, bronchoalveolar lavage, blood cultures), co-infections, treatments, and mortality rates.

Main Results:

• A notable increase in histoplasmosis cases was observed in the latter three years of the study period.
• Cutaneous lesions were common (64.3%), with Histoplasma capsulatum confirmed by Giemsa staining of skin scrapings.
• Respiratory symptoms were frequent, and blood cultures yielded H. capsulatum in 58.2% of cases. Mortality rate was 19.9%.

Conclusions:

• Disseminated histoplasmosis remains a significant threat to HIV/AIDS patients, with a concerning rise in incidence in recent years.
• Prompt recognition of clinical signs, particularly skin manifestations, and utilization of diagnostic tools like skin scraping and blood cultures are vital for timely diagnosis.
• Effective treatment, often involving amphotericin B or itraconazole, is critical, but high mortality underscores the need for increased clinical vigilance and early intervention.