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Histoplasmosis in eastern India: the tip of the iceberg?

R P Goswami1, N Pramanik, D Banerjee

  • 1Department of Tropical Medicine, Calcutta School of Tropical Medicine, West Bengal, India.

Transactions of the Royal Society of Tropical Medicine and Hygiene
|March 4, 2000
PubMed

Insights

Systemic histoplasmosis is a serious fungal infection, especially in immunocompromised individuals. Recent cases in Eastern India suggest potential under-diagnosis and under-reporting of this disseminated disease.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Public Health

Background:

  • Systemic histoplasmosis presents diverse clinical manifestations, posing diagnostic challenges.
  • Immunocompromised patients are particularly vulnerable to severe histoplasmosis.
  • Previous reports from India indicated limited cases, primarily around Calcutta.

Observation:

  • Five new cases of systemic histoplasmosis were diagnosed in Eastern India within two years.
  • All diagnosed patients presented with disseminated disease and multisystem involvement.
  • Two patients exhibited bilateral adrenal enlargement; two had diabetes, and one was HIV-infected.

Findings:

  • The recent cluster of cases suggests a potential increase or improved detection of histoplasmosis in India.
  • Multisystem involvement, including adrenal glands, is a key feature of disseminated disease.
  • Comorbidities like diabetes and HIV infection may influence disease presentation and severity.

Implications:

  • Increased clinical suspicion and diagnostic efforts are crucial for timely histoplasmosis diagnosis in India.
  • Public health strategies may need re-evaluation to address potential under-reporting.
  • Further research is warranted to understand the epidemiology and clinical spectrum of histoplasmosis in the region.

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