%0 Journal Article %1 antinori_histoplasmosis_2006 %A Antinori, Spinello %A Magni, Carlo %A Nebuloni, Manuela %A Parravicini, Carlo %A Corbellino, Mario %A Sollima, Salvatore %A Galimberti, Laura %A Ridolfo, Anna Lisa %A Wheat, L Joseph %D 2006 %J Medicine %K Adult, Agents, Antifungal Diagnosis, Differential, Europe, Fatal Female, Histoplasmosis, Humans, Infections, Male, Outcome, Prognosis {HIV} %N 1 %P 22--36 %R 10.1097/01.md.0000199934.38120.d4 %T Histoplasmosis among human immunodeficiency virus-infected people in Europe: report of 4 cases and review of the literature %U http://www.ncbi.nlm.nih.gov/pubmed/16523050 %V 85 %X We reviewed the clinical, microbiologic, and outcome characteristics of 72 patients with human immunodeficiency virus (HIV)-associated histoplasmosis (4 newly described) reported in Europe over 20 years (1984-2004). Seven cases (9.7\%) were acquired in Europe (autochthonous), whereas the majority involved a history of travel or arrival from endemic areas. The diagnosis of progressive disseminated histoplasmosis (PDH) was made during life in 63 patients (87.5\%) and was the acquired immunodeficiency syndrome (AIDS)-presenting illness in 44 (61.1\%). Disease was widespread in 66 patients (91.7\%) and localized in 6 (8.3\%), with the skin being the most frequent site of localized infection. Overall skin involvement was reported in 47.2\% of the patients regardless of whether histoplasmosis was acquired in Africa or South America. Reticulonodular or diffuse interstial infiltrates occurred in 52.8\%. The diagnosis was made during life by histopathology plus culture in 44 patients (69.8\%), histopathology alone in 18 (28.5\%), and culture alone in 1 (1.5\%). During the induction phase amphotericin B and itraconazole (74.6\%) were the single most frequently used drugs. Both drugs were also used either in combination (10.2\%) or in sequential therapy (11.8\%). Cumulative mortality rate during the induction phase of treatment was 15.2\%. Overall, 37 patients died (57.8\%); death occurred early in the course in 18 (28.1\%). Seven of 40 patients (17.5\%) who responded to therapy subsequently relapsed. Autopsy data in 13 patients confirmed the widespread disseminated nature of histoplasmosis (85\%) among AIDS patients with a median of 4.5 organs involved. The results of the present report highlight the need to consider the diagnosis of PDH among patients with AIDS in Europe presenting with a febrile illness who have traveled to or who originated from an endemic area.

@article{antinori_histoplasmosis_2006, abstract = {We reviewed the clinical, microbiologic, and outcome characteristics of 72 patients with human immunodeficiency virus {(HIV)-associated} histoplasmosis (4 newly described) reported in Europe over 20 years (1984-2004). Seven cases (9.7\%) were acquired in Europe (autochthonous), whereas the majority involved a history of travel or arrival from endemic areas. The diagnosis of progressive disseminated histoplasmosis {(PDH)} was made during life in 63 patients (87.5\%) and was the acquired immunodeficiency syndrome {(AIDS)-presenting} illness in 44 (61.1\%). Disease was widespread in 66 patients (91.7\%) and localized in 6 (8.3\%), with the skin being the most frequent site of localized infection. Overall skin involvement was reported in 47.2\% of the patients regardless of whether histoplasmosis was acquired in Africa or South America. Reticulonodular or diffuse interstial infiltrates occurred in 52.8\%. The diagnosis was made during life by histopathology plus culture in 44 patients (69.8\%), histopathology alone in 18 (28.5\%), and culture alone in 1 (1.5\%). During the induction phase amphotericin B and itraconazole (74.6\%) were the single most frequently used drugs. Both drugs were also used either in combination (10.2\%) or in sequential therapy (11.8\%). Cumulative mortality rate during the induction phase of treatment was 15.2\%. Overall, 37 patients died (57.8\%); death occurred early in the course in 18 (28.1\%). Seven of 40 patients (17.5\%) who responded to therapy subsequently relapsed. Autopsy data in 13 patients confirmed the widespread disseminated nature of histoplasmosis (85\%) among {AIDS} patients with a median of 4.5 organs involved. The results of the present report highlight the need to consider the diagnosis of {PDH} among patients with {AIDS} in Europe presenting with a febrile illness who have traveled to or who originated from an endemic area.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Antinori, Spinello and Magni, Carlo and Nebuloni, Manuela and Parravicini, Carlo and Corbellino, Mario and Sollima, Salvatore and Galimberti, Laura and Ridolfo, Anna Lisa and Wheat, L Joseph}, biburl = {https://www.bibsonomy.org/bibtex/24341cd09cda7ab86c2737b18adc98efc/jelias}, doi = {10.1097/01.md.0000199934.38120.d4}, interhash = {182e8609659df5739bea150fa757b76c}, intrahash = {4341cd09cda7ab86c2737b18adc98efc}, issn = {0025-7974}, journal = {Medicine}, keywords = {Adult, Agents, Antifungal Diagnosis, Differential, Europe, Fatal Female, Histoplasmosis, Humans, Infections, Male, Outcome, Prognosis {HIV}}, month = jan, note = {{PMID:} 16523050}, number = 1, pages = {22--36}, shorttitle = {Histoplasmosis among human immunodeficiency virus-infected people in Europe}, timestamp = {2011-03-11T10:06:23.000+0100}, title = {Histoplasmosis among human immunodeficiency virus-infected people in Europe: report of 4 cases and review of the literature}, url = {http://www.ncbi.nlm.nih.gov/pubmed/16523050}, volume = 85, year = 2006 }