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Hsu JC, Chang PH, Tai CH, Chen YC. Histoplasmosis in Taiwan: Case Summary and Literature Review. Life (Basel) 2024; 14:738. [PMID: 38929720 PMCID: PMC11204960 DOI: 10.3390/life14060738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2024] [Revised: 06/01/2024] [Accepted: 06/05/2024] [Indexed: 06/28/2024] Open
Abstract
Histoplasmosis is a global infection caused by the thermally dimorphic fungus, Histoplasma capsulatum complex. It is endemic in the United States, as well as in Central and South America. In Taiwan, histoplasmosis is rare, with the first reported case not occurring until 1977. We summarized a total of 17 cases reported in Taiwan over the past 40 years and provided detailed descriptions for four probable indigenous cases. Due to the lack of rapid diagnostic tools and clinical suspicion, histoplasmosis may be underdiagnosed in Taiwan. We recognize that a limitation of our review is the lack of data on the environmental surveillance for H. capsulatum complex in Taiwan. Conducting a further phylogenetic analysis on both environmental and clinical isolates would provide valuable evidence for the region.
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Affiliation(s)
- Jui-Chi Hsu
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (J.-C.H.); (C.-H.T.)
| | - Po-Hsun Chang
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan;
| | - Chien-Hsiang Tai
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (J.-C.H.); (C.-H.T.)
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yi-Chun Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan; (J.-C.H.); (C.-H.T.)
- College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
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Zerbato V, Di Bella S, Pol R, D’Aleo F, Angheben A, Farina C, Conte M, Luzzaro F, Luzzati R, Principe L. Endemic Systemic Mycoses in Italy: A Systematic Review of Literature and a Practical Update. Mycopathologia 2023; 188:307-334. [PMID: 37294504 PMCID: PMC10386973 DOI: 10.1007/s11046-023-00735-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 04/02/2023] [Indexed: 06/10/2023]
Abstract
Endemic systemic mycoses such as blastomycosis, coccidioidomycosis, histoplasmosis, talaromycosis, paracoccidioidomycosis are emerging as an important cause of morbidity and mortality worldwide. We conducted a systematic review on endemic systemic mycoses reported in Italy from 1914 to nowadays. We found out: 105 cases of histoplasmosis, 15 of paracoccidioidomycosis, 10 of coccidioidomycosis, 10 of blastomycosis and 3 of talaromycosis. Most cases have been reported in returning travelers and expatriates or immigrants. Thirtytwo patients did not have a story of traveling to an endemic area. Fortysix subjects had HIV/AIDS. Immunosuppression was the major risk factor for getting these infections and for severe outcomes. We provided an overview on microbiological characteristics and clinical management principles of systemic endemic mycoses with a focus on the cases reported in Italy.
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Affiliation(s)
- Verena Zerbato
- Infectious Diseases Unit, Trieste University Hospital (ASUGI), Piazza dell’Ospitale 1, 34125 Trieste, Italy
| | - Stefano Di Bella
- Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 34149 Trieste, Italy
| | - Riccardo Pol
- Infectious Diseases Unit, Trieste University Hospital (ASUGI), Piazza dell’Ospitale 1, 34125 Trieste, Italy
| | - Francesco D’Aleo
- Microbiology and Virology Unit, Great Metropolitan Hospital “Bianchi Melacrino Morelli”, 89124 Reggio Calabria, Italy
| | - Andrea Angheben
- Department of Infectious, Tropical Diseases and Microbiology, IRCCS Sacro Cuore - Don Calabria Hospital, 37024 Negrar di Valpolicella, Verona, Italy
| | - Claudio Farina
- Microbiology and Virology Laboratory, ASST “Papa Giovanni XXIII”, 24127 Bergamo, Italy
| | - Marco Conte
- Microbiology and Virology Unit, Great Metropolitan Hospital “Bianchi Melacrino Morelli”, 89124 Reggio Calabria, Italy
| | - Francesco Luzzaro
- Clinical Microbiology and Virology Unit, “A. Manzoni” Hospital, 23900 Lecco, Italy
| | | | - Roberto Luzzati
- Clinical Department of Medical, Surgical and Health Sciences, Trieste University, 34149 Trieste, Italy
| | - Luigi Principe
- Clinical Pathology and Microbiology Unit, “S. Giovanni di Dio” Hospital, 88900 Crotone, Italy
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Abstract
Histoplasmosis is one of the commonest endemic mycoses in the Americas yet is often underdiagnosed and neglected as a public health priority. This review outlines the evolving understanding of its epidemiology and the clinical syndromes of histoplasmosis, in addition to up-to-date diagnostic and treatment guidelines. A focus on histoplasmosis in advanced HIV is included. The challenges pertinent to histoplasmosis management in Latin America, with recommendations made through international expert consensus are discussed.
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Affiliation(s)
- Ana Belén Araúz
- Department of Infectious Diseases, Pasteur Suite, Ealing Hospital, London North West University Healthcare NHS Trust, Uxbridge Road, London, UB1 3HW, UK; Infectious Diseases Department, Hospital Santo Tomas, Avenida Balboa, Panama City, Panama
| | - Padmasayee Papineni
- Infectious Diseases Department, Hospital Santo Tomas, Avenida Balboa, Panama City, Panama.
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Staffolani S, Buonfrate D, Angheben A, Gobbi F, Giorli G, Guerriero M, Bisoffi Z, Barchiesi F. Acute histoplasmosis in immunocompetent travelers: a systematic review of literature. BMC Infect Dis 2018; 18:673. [PMID: 30563472 PMCID: PMC6299618 DOI: 10.1186/s12879-018-3476-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 10/31/2018] [Indexed: 11/15/2022] Open
Abstract
Background Histoplasmosis is a fungal infection highly endemic in the American continent. The disease can be severe in immunocompromised subjects. In immunocompetent subjects the clinical manifestations are variable. Aim of this work was to review the cases of acute histoplasmosis in immunocompetent travelers reported in literature. Methods A systematic review of literature was conducted. Electronic search was performed in Pubmed and LILACS. Two reviewers independently extracted data on demographic, clinical and radiological features, and treatment. Cases were classified according to Wheat’s definitions. Results Seventy-one studies were included in the analysis, comprising a total of 814 patients. Twenty-one patients diagnosed at the Centre of Tropical Diseases, Negrar (VR), Italy were also included. The most common travel destination was Central America (168 people, 29.8%); the most common way of exposure to histoplasma was the exploration of caves and/or contact with bat guano (349 people, 60.9%). The multivariate logistic regression model showed association between the development of disseminated histoplasmosis (DH) and activities that involved the exploration of caves and/or the contact with bats’ guano (adjusted OR: 34.20 95% CI: 5.29 to 220.93) or other outdoor activities (adjusted OR: 4.61 95% CI: 1.09 to 19.56). No significant difference in the attack rate between countries of destination was observed (p-value: 0.8906, Kruskal-Wallis test). Conclusions Histoplasmosis often causes no or mild symptoms in immunocompetent individuals, although a severe syndrome may occur. The infection can mimic other diseases, and the epidemiological risk of exposure is an important clue to raise the index of suspicion. Electronic supplementary material The online version of this article (10.1186/s12879-018-3476-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Silvia Staffolani
- Centro per le Malattie Tropicali, IRCCS Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Sacro Cuore - Don Calabria, Via Don Sempreboni 5, 37024, Verona, Negrar, Italy. .,SOD Malattie Infettive emergenti e degli immunodepressi, Azienda Ospedaliero Universitaria, Ospedali Riuniti di Ancona, Via Conca Torrette, Ancona, Italy.
| | - Dora Buonfrate
- Centro per le Malattie Tropicali, IRCCS Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Sacro Cuore - Don Calabria, Via Don Sempreboni 5, 37024, Verona, Negrar, Italy
| | - Andrea Angheben
- Centro per le Malattie Tropicali, IRCCS Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Sacro Cuore - Don Calabria, Via Don Sempreboni 5, 37024, Verona, Negrar, Italy
| | - Federico Gobbi
- Centro per le Malattie Tropicali, IRCCS Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Sacro Cuore - Don Calabria, Via Don Sempreboni 5, 37024, Verona, Negrar, Italy
| | - Giovanni Giorli
- Centro per le Malattie Tropicali, IRCCS Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Sacro Cuore - Don Calabria, Via Don Sempreboni 5, 37024, Verona, Negrar, Italy
| | - Massimo Guerriero
- Computer Sciences, Dipartimento di Economia Aziendale, Università degli Studi di Verona, Strada le Grazie, Verona, Italy
| | - Zeno Bisoffi
- Centro per le Malattie Tropicali, IRCCS Istituto di Ricovero e Cura a Carattere Scientifico, Ospedale Sacro Cuore - Don Calabria, Via Don Sempreboni 5, 37024, Verona, Negrar, Italy.,Sezione di Malattie Infettive e Tropicali, Dipartimento di Diagnostica e Sanità Pubblica, Università di Verona, Strada le Grazie, Verona, Italy
| | - Francesco Barchiesi
- Clinica Malattie Infettive, Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, Azienda Ospedaliera Umberto I° Via Conca Torrette, Ancona, Italy
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Gundacker ND, Rolfe RJ, Rodriguez JM. Infections associated with adventure travel: A systematic review. Travel Med Infect Dis 2017; 16:3-10. [PMID: 28351605 PMCID: PMC7185378 DOI: 10.1016/j.tmaid.2017.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 12/16/2022]
Abstract
AIM To review infections associated with adventure travel. METHODS The PubMed, Embase and Scopus databases were searched combining the words infection with the following keywords: rafting, whitewater, surfing, (surfer* or windsurf*), (caves or caving or spelunking), (triathlon or trekking) or (hiking or adventure race), bicycling, backpacking, (mountain climb* or bouldering), horseback riding, orienteering, trekking, and skiing. RESULTS Adventure travel is becoming much more common among travelers and it is associated with a subset of infectious diseases including: leptospirosis, schistosomiasis, viral hemorrhagic fevers, rickettsial diseases and endemic mycosis. Caving and whitewater rafting places individuals at particular risk of leptospirosis, schistosomiasis and endemic mycosis, while adventure races also place individuals at high risk of a variety of infections including campylobacter, norovirus and leptospirosis. CONCLUSION Travel practitioners need to be aware of the risks associated with adventure travel and should educate individuals about the risks associated with various activities. Doxycycline prophylaxis should be considered for travelers who are susceptible to leptospirosis due to participation in high-risk sports such as whitewater rafting, caving or adventure races.
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Affiliation(s)
- Nathan D Gundacker
- University of Alabama at Birmingham, 1900 University Blvd, THT 229, Birmingham, AL 35294, United States.
| | - Robert J Rolfe
- University of Alabama at Birmingham, 1900 University Blvd, THT 229, Birmingham, AL 35294, United States.
| | - J Martin Rodriguez
- University of Alabama at Birmingham, 1900 University Blvd, THT 229, Birmingham, AL 35294, United States.
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Segel MJ, Rozenman J, Lindsley MD, Lachish T, Berkman N, Neuberger A, Schwartz E. Histoplasmosis in Israeli travelers. Am J Trop Med Hyg 2015; 92:1168-72. [PMID: 25918200 DOI: 10.4269/ajtmh.14-0509] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 01/09/2015] [Indexed: 11/07/2022] Open
Abstract
Histoplasmosis is a common endemic human mycoses acquired mostly in the Americas. We reviewed 23 cases of histoplasmosis in Israeli travelers; 22 had traveled to Central or South America and one to North America. Fourteen cases had been exposed to bat habitats and were symptomatic, presenting ≤ 3 months after their return. Asymptomatic patients (N = 9) were diagnosed during the evaluation of incidental radiological findings or because a travel partner had been suspected of Histoplasma infection, 16-120 months after their return. Serological testing was positive in 75% of symptomatic cases but only 22% of asymptomatic cases. Histoplasmosis should be considered in travelers returning from the Americas with respiratory or febrile illness within weeks of return, particularly if exposed to bat habitats. Travel history is essential in patients presenting with pulmonary nodules, even years after travel to endemic countries.
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Affiliation(s)
- Michael J Segel
- Institute of Pulmonology, Department of Imaging, Internal Medicine "C" and Center for Geographic Medicine, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel; Institute of Pulmonology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Unit of Infectious Diseases, Internal Medicine B, Rambam Medical Center, Haifa, Israel
| | - Judith Rozenman
- Institute of Pulmonology, Department of Imaging, Internal Medicine "C" and Center for Geographic Medicine, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel; Institute of Pulmonology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Unit of Infectious Diseases, Internal Medicine B, Rambam Medical Center, Haifa, Israel
| | - Mark D Lindsley
- Institute of Pulmonology, Department of Imaging, Internal Medicine "C" and Center for Geographic Medicine, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel; Institute of Pulmonology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Unit of Infectious Diseases, Internal Medicine B, Rambam Medical Center, Haifa, Israel
| | - Tamar Lachish
- Institute of Pulmonology, Department of Imaging, Internal Medicine "C" and Center for Geographic Medicine, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel; Institute of Pulmonology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Unit of Infectious Diseases, Internal Medicine B, Rambam Medical Center, Haifa, Israel
| | - Neville Berkman
- Institute of Pulmonology, Department of Imaging, Internal Medicine "C" and Center for Geographic Medicine, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel; Institute of Pulmonology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Unit of Infectious Diseases, Internal Medicine B, Rambam Medical Center, Haifa, Israel
| | - Ami Neuberger
- Institute of Pulmonology, Department of Imaging, Internal Medicine "C" and Center for Geographic Medicine, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel; Institute of Pulmonology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Unit of Infectious Diseases, Internal Medicine B, Rambam Medical Center, Haifa, Israel
| | - Eli Schwartz
- Institute of Pulmonology, Department of Imaging, Internal Medicine "C" and Center for Geographic Medicine, Chaim Sheba Medical Center, Tel HaShomer, Ramat Gan, Israel; Sackler Medical School, Tel Aviv University, Tel Aviv, Israel; Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, Georgia; Infectious Diseases Unit, Shaare-Zedek Medical Center, Jerusalem, Israel; Institute of Pulmonology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Unit of Infectious Diseases, Internal Medicine B, Rambam Medical Center, Haifa, Israel
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Histoplasmosis infections worldwide: thinking outside of the Ohio River valley. CURRENT TROPICAL MEDICINE REPORTS 2015; 2:70-80. [PMID: 26279969 DOI: 10.1007/s40475-015-0044-0] [Citation(s) in RCA: 139] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In the United States, histoplasmosis is generally thought to occur mainly in the Ohio and Mississippi River Valleys, and the classic map of histoplasmosis distribution reflecting this is second nature to many U.S. physicians. With the advent of the HIV pandemic reports of patients with progressive disseminated histoplasmosis and AIDS came from regions of known endemicity, as well as from regions not thought to be endemic for histoplasmosis throughout the world. In addition, our expanding armamentarium of immunosuppressive medications and biologics has increased the diagnosis of histoplasmosis worldwide. While our knowledge of areas in which histoplasmosis is endemic has improved, it is still incomplete. Our contention is that physicians should consider histoplasmosis with the right constellations of symptoms in any febrile patient with immune suppression, regardless of geographic location or travel history.
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Catania J, Martin SS, Corey GR, Sexton DS. Diagnostic dilemma in a returning traveler with fever. Diagn Microbiol Infect Dis 2013; 77:85-6. [PMID: 23871414 DOI: 10.1016/j.diagmicrobio.2013.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 05/13/2013] [Accepted: 05/16/2013] [Indexed: 10/26/2022]
Abstract
This case report of fever of unknown origin in a returning traveler from South America illustrates the need for a thorough understanding of limitations of laboratory testing modalities in order to prevent delays in diagnosis in potentially fatal but curable diseases.
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Hsu LY, Wijaya L, Shu-Ting Ng E, Gotuzzo E. Tropical Fungal Infections. Infect Dis Clin North Am 2012; 26:497-512. [DOI: 10.1016/j.idc.2012.02.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Alonso D, Muñoz J, Letang E, Salvadó E, Cuenca-Estrella M, Buitrago MJ, Torres JM, Gascón J. Imported acute histoplasmosis with rheumatologic manifestations in Spanish travelers. J Travel Med 2007; 14:338-42. [PMID: 17883466 DOI: 10.1111/j.1708-8305.2007.00138.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- David Alonso
- International Health Center, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clìnic Barcelona, and Mycology Research Unit, Universitat Autónoma de Barcelona, Spain.
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Farina C, Rizzi M, Ricci L, Gabbi E, Caligaris S, Goglio A. Imported and autochthonous histoplasmosis in Italy: new cases and old problems. Rev Iberoam Micol 2006; 22:169-71. [PMID: 16309355 DOI: 10.1016/s1130-1406(05)70034-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the past the Italian soil was considered as a low-endemic pabulum for H. capsulatum var. capsulatum and only few autochthonous cases of histoplasmosis were reported in Italy, especially in the Po valley. The aim of the paper was to evaluate this possibility by reviewing the literature and providing our own personal data. Four additional cases of histoplasmosis were observed during 1999-2003 in AIDS immigrant or in Italian citizens, and in travellers to endemic areas. One of the AIDS patients was an autochthonous case of histoplasmosis. The Italian literature was reviewed. Recent cases and literature data confirm the possible autochthonous presence of histoplasmosis in Italy, especially in the Northern regions.
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Affiliation(s)
- Claudio Farina
- Unità Operativa Microbiologia e Virologia, Azienda Ospedaliera Ospedali Riuniti di Bergamo, Bergamo, Italy.
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Maloney SA, Weinberg M. Prevention of infectious diseases among international pediatric travelers: considerations for clinicians. SEMINARS IN PEDIATRIC INFECTIOUS DISEASES 2004; 15:137-49. [PMID: 15480960 PMCID: PMC7119036 DOI: 10.1053/j.spid.2004.05.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
An estimated 1.9 million children travel overseas annually. Infectious disease risks associated with international travel are diverse and depend on the destination, planned activities, and baseline medical history. Children have special needs and vulnerabilities that should be addressed when preparing for travel abroad. Children should have a pretravel health assessment that includes recommendations for both routine and special travel-related vaccination; malaria chemoprophylaxis, if indicated; and prevention counseling regarding insect and animal exposures, food and water safety, and avoiding injuries. Special consideration should be given to children with chronic diseases. Families should be given anticipatory guidance for management of potential illnesses and information about the location of medical resources overseas.
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Affiliation(s)
- Susan A Maloney
- Division of Global Migration and Quarantine, National Center for Infectious Disease, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
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Weinberg M, Weeks J, Lance-Parker S, Traeger M, Wiersma S, Phan Q, Dennison D, MacDonald P, Lindsley M, Guarner J, Connolly P, Cetron M, Hajjeh R. Severe histoplasmosis in travelers to Nicaragua. Emerg Infect Dis 2004; 9:1322-5. [PMID: 14609473 PMCID: PMC3033095 DOI: 10.3201/eid0910.030049] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We investigated an outbreak of unexpectedly severe histoplasmosis among 14 healthy adventure travelers from the United States who visited a bat-infested cave in Nicaragua. Although histoplasmosis has rarely been reported to cause serious illness among travelers, this outbreak demonstrates that cases may be severe among travelers, even young, healthy persons.
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Affiliation(s)
- Michelle Weinberg
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop E03, Atlanta, GA 30333, USA.
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Calza L, Manfredi R, Donzelli C, Marinacci G, Colangeli V, Chiodo F. Disseminated histoplasmosis with atypical cutaneous lesions in an Italian HIV-infected patient: another autochtonous case. HIV Med 2003; 4:145-8. [PMID: 12702136 DOI: 10.1046/j.1468-1293.2003.00144.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Disseminated histoplasmosis is recognized as a common AIDS-defining opportunistic disease in endemic areas (Americas, Africa, East Asia), while it is rarely described in Europe, usually in individuals returning from endemic regions, or following endogenous reactivation of a latent infection imported long before from overseas countries. However, reports of autochtonous cases in Europe suggest the possible, endemic presence of Histoplasma capsulatum in some European regions, such as the South of France or the Po valley in Italy. A case of disseminated histoplasmosis with atypical, papular and ulcerate skin lesions in an Italian HIV-infected patient, without history of travels outside his native region, is described. Our patient represents the fifth autochtonous case of AIDS-associated histoplasmosis described in Italy.
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Affiliation(s)
- L Calza
- Department of Clinical and Experimental Medicine, Section of Infectious Diseases, University of Bologna, S.Orsola Hospital, Bologna, Italy.
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Panackal AA, Hajjeh RA, Cetron MS, Warnock DW. Fungal infections among returning travelers. Clin Infect Dis 2002; 35:1088-95. [PMID: 12384843 DOI: 10.1086/344061] [Citation(s) in RCA: 104] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2002] [Revised: 07/16/2002] [Indexed: 11/03/2022] Open
Abstract
Endemic mycoses, such as histoplasmosis, coccidioidomycosis, and penicilliosis, have emerged as important health threats among travelers to regions of the world where these infections are endemic. Travelers have developed fungal infections as a result of a wide range of recreational and work activities, many of which have involved well-recognized risk factors for these diseases. In some instances, infections have been acquired during short trips, whereas, in other instances, infection has been acquired during a longer period of residence in an area where the infection is endemic. Travelers need to be made aware of the risks of acquiring mycotic diseases when visiting such regions. Health care providers need to consider these infections in their differential diagnosis among returning travelers with respiratory illness and should be familiar with the treatment and prevention of these diseases.
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Affiliation(s)
- Anil A Panackal
- Epidemic Intelligence Service, Epidemiology Program Office, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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Abstract
Histoplasma capsulatum is a dimorphic fungus with the mycelial form producing spores that are readily airborne and able to reach small bronchi and alveoli. Isolation of the mycelial form of H. capsulatum in nature shows a striking correlation with moist, acidic soils, frequently contaminated with bird or bat excreta. Bats, but not birds, may be infected by H. capsulatum and may excrete the fungus in their feces. Skin test surveys show that the infectious agent is present worldwide in the areas between 45 degrees north and 30 degrees south of the equator. Clusters of cases may occur because of the disturbance of soil contaminated with H. capsulatum, or by visiting bat caves. Cave-associated histoplasmosis has been reported from the Americas, Africa, Oceania, and Africa. Recently, cave-associated histoplasmosis has been reported in travelers returning from Costa Rica and Peru. We report a cluster of cave-associated acute histoplasmosis that occurred in college students returning from Ecuador. Advice regarding histoplasmosis prevention should be given to travelers planning to visit bat-infested caves, and histoplasmosis should be considered in the differential diagnosis of febrile illness in returning travelers with a history of epidemiologic or geographic exposure.
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Affiliation(s)
- H Valdez
- University Hospitals of Cleveland, Department of Internal Medicine, Division of Infectious Diseases and Case Western Reserve University, Cleveland, Ohio, USA
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