Atul K Patel1, Ketan K Patel1, Harsh Toshniwal2, Swati Gohel1, Arunaloke Chakrabarti3. 1. Infectious Diseases Clinic, "VEDANTA" Institute of Medical Sciences, Ahmedabad, Gujarat, India. 2. Infectious Diseases and Tropical Medicine Clinic, Ahmedabad, Gujarat, India. 3. Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
PURPOSE OF STUDY: The western and North-Western parts of India are usually considered non-endemic for histoplasmosis. On the contrary, we observe histoplasmosis cases with relatively higher frequency from this region although the awareness and laboratory facility to diagnose the disease are not adequate. Hence, we planned the present retrospective study to compile the cases and to analyse different clinical parameters. MATERIALS AND METHODS: Medical records of the patients diagnosed with histoplasmosis during January 2012-August 2017 at two infectious disease clinics of Ahmedabad were included in this study. RESULTS: During the study, 12 cases of histoplasmosis were diagnosed. The median age of the patients was 53 years; all males except one. The diagnosis of histoplasmosis was confirmed on histopathology for 11 cases, and one patient was diagnosed as probable histoplasmosis. The patients were either from Gujarat or Rajasthan without any travel history to endemic zone of histoplasmosis, except one patient. The majority (67%) of the patients had no apparent immunosuppression. Adrenal enlargement, oral ulcers and lymphadenopathy were common presentations in four patients each. We lost two patients in follow-up, and rest 10 patients responded to either to amphotericin B deoxycholate and/or itraconazole therapy. CONCLUSION: This study highlights that Gujarat and Rajasthan are an endemic region for histoplasmosis, and a systematic study is required to understand epidemiology of the disease. Histoplasmosis should be a differential diagnosis in a patient presenting with adrenal enlargement, lymphadenopathy, oral ulcers and fever of unknown origin in this region.
PURPOSE OF STUDY: The western and North-Western parts of India are usually considered non-endemic for histoplasmosis. On the contrary, we observe histoplasmosis cases with relatively higher frequency from this region although the awareness and laboratory facility to diagnose the disease are not adequate. Hence, we planned the present retrospective study to compile the cases and to analyse different clinical parameters. MATERIALS AND METHODS: Medical records of the patients diagnosed with histoplasmosis during January 2012-August 2017 at two infectious disease clinics of Ahmedabad were included in this study. RESULTS: During the study, 12 cases of histoplasmosis were diagnosed. The median age of the patients was 53 years; all males except one. The diagnosis of histoplasmosis was confirmed on histopathology for 11 cases, and one patient was diagnosed as probable histoplasmosis. The patients were either from Gujarat or Rajasthan without any travel history to endemic zone of histoplasmosis, except one patient. The majority (67%) of the patients had no apparent immunosuppression. Adrenal enlargement, oral ulcers and lymphadenopathy were common presentations in four patients each. We lost two patients in follow-up, and rest 10 patients responded to either to amphotericin B deoxycholate and/or itraconazole therapy. CONCLUSION: This study highlights that Gujarat and Rajasthan are an endemic region for histoplasmosis, and a systematic study is required to understand epidemiology of the disease. Histoplasmosis should be a differential diagnosis in a patient presenting with adrenal enlargement, lymphadenopathy, oral ulcers and fever of unknown origin in this region.
Authors: Maria Lucia Taylor; María Del Rocío Reyes-Montes; Daniel A Estrada-Bárcenas; Rosely M Zancopé-Oliveira; Gabriela Rodríguez-Arellanes; José Antonio Ramírez Journal: Appl Environ Microbiol Date: 2022-03-09 Impact factor: 5.005
Authors: Nida Ashraf; Ryan C Kubat; Victoria Poplin; Antoine A Adenis; David W Denning; Laura Wright; Orion McCotter; Ilan S Schwartz; Brendan R Jackson; Tom Chiller; Nathan C Bahr Journal: Mycopathologia Date: 2020-02-10 Impact factor: 2.574