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Cornell TR, Conteh B, Drammeh L, Jeffang F, Sallah E, Kijera A, Jarju M, Karim M, Khan E, Ceesay PO, Manneh E, Wootton DG, Pinchbeck G, Scantlebury CE. Histoplasma seropositivity and environmental risk factors for exposure in a general population in Upper River Region, The Gambia: A cross-sectional study. One Health 2024; 18:100717. [PMID: 38576541 PMCID: PMC10992707 DOI: 10.1016/j.onehlt.2024.100717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/26/2024] [Indexed: 04/06/2024] Open
Abstract
Robust surveillance of Histoplasma species is warranted in endemic regions, including investigation of community-level transmission dynamics. This cross-sectional study explored anti-Histoplasma antibody seroprevalence and risk factors for exposure in a general population in Upper River Region (URR), The Gambia. Study participants were recruited (December 2022-March 2023) by random household sampling across 12 Enumeration Areas (EAs) of URR. A questionnaire and clinical examination were performed; exploring demographic, clinical and environmental risk factors for Histoplasma exposure. One venous blood sample per participant was subject to IMMY Latex Agglutination Histoplasma test to determine presence of a recent IgM response to Histoplasma. Seropositivity risk factors were explored by multi-level, multivariable logistic regression analysis. The study population (n = 298) aged 5-83 years, demonstrated a positively skewed age distribution and comprised 55.4% females. An apparent seroprevalence of 18.8% (n = 56/298, 95% CI 14.5-23.7%) was measured using the LAT. A multivariable model demonstrated increased odds of Histoplasma seropositivity amongst female participants (OR = 2.41 95% CI 1.14-5.10); and participants reporting involvement in animal manure management (OR = 4.21 95% CI 1.38-12.90), and management of domestic animals inside the compound at night during the dry season (OR = 10.72 95% CI 2.02-56.83). Increasing age (OR = 0.96 95% CI 0.93-0.98) was associated with decreased odds of seropositivity. Clustering at EA level was responsible for 17.2% of seropositivity variance. The study indicates frequent recent Histoplasma exposure and presents plausible demographic and environmental risk factors for seropositivity. Histoplasma spp. characterisation at this human-animal-environment interface is warranted, to determine public health implications of environmental reservoirs in The Gambia. The study was supported by Wellcome Trust (206,638/Z/17/Z to CES) and a University of Liverpool-funded PhD studentship (to TRC).
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Affiliation(s)
- Tessa Rose Cornell
- Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, UK
| | - Bakary Conteh
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Lamin Drammeh
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Foday Jeffang
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Ebrima Sallah
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Alkali Kijera
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Mustapha Jarju
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Mehrab Karim
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Ebrima Khan
- Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Pa Ousman Ceesay
- Gambia Bureau of Statistics (GBoS), Ministry of Finance and Economic Affairs, The Gambia
| | - Ebrima Manneh
- Gambia Bureau of Statistics (GBoS), Ministry of Finance and Economic Affairs, The Gambia
| | | | - Dan G. Wootton
- Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, UK
- NIHR Health Protection Research Unit in Emerging & Zoonotic Diseases, University of Liverpool, UK
| | - Gina Pinchbeck
- Institute of Infection, Veterinary and Ecological Sciences (IVES), University of Liverpool, UK
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Choudhary A, Jangid NC, Shah B. Penile histoplasmosis in an immunocompetent host: A rare intruder in genital ulcer. J Eur Acad Dermatol Venereol 2023; 37:e221-e222. [PMID: 36268778 DOI: 10.1111/jdv.18675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/06/2022] [Indexed: 01/19/2023]
Affiliation(s)
- Ankita Choudhary
- Department of Dermatology, B.J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India
| | - Neha Chetan Jangid
- Department of Dermatology, B.J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India
| | - Bela Shah
- Department of Dermatology, B.J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India
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Batista JM, Martins MAP, Bertollo CM. Primary cutaneous histoplasmosis difficult to treat in immunocompetent patient: case report and literature review. EINSTEIN-SAO PAULO 2021; 19:eRC5488. [PMID: 34037087 PMCID: PMC8121373 DOI: 10.31744/einstein_journal/2021rc5488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 01/12/2021] [Indexed: 01/19/2023] Open
Abstract
Histoplasmosis is an infection caused by the dimorphic fungus Histoplasma capsulatum. The disease is endemic in several regions of tropical and temperate climate. The fungus presents opportunistic behavior, causing widespread infection in immunocompromised patients, resulting from complication of primary pulmonary infection, due to exogenous reinfection or reactivation of a quiescent source. In immunocompetent individuals, approximately 95% of pulmonary infections are asymptomatic. However, prolonged exposure to high amount spores may lead to acute or chronic lung infection. Due to the low amount of inoculum, primary cutaneous histoplasmosis caused by traumatic implantation is extremely rare and effectively treated with triazoles. Thus, the present study aims to report a case of primary cutaneous histoplasmosis that is difficult to treat in an immunocompetent patient, and to review the literature on the incidence of drug-resistant Histoplasma capsulatum strains in clinical practice.
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Kondo RN, Scalone FDM, Armani A, Gordan AN. Primary Localized Histoplasmosis: Atypical Presentation in Immunocompetent Patient - Case Report. Indian J Dermatol 2021; 66:226. [PMID: 34188307 PMCID: PMC8208262 DOI: 10.4103/ijd.ijd_599_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Affiliation(s)
- Rogerio N Kondo
- Department of Dermatology, Regional University Hospital of Northern Paraná, State University of Londrina, Londrina, Brazil. E-mail:
| | - Fabiana De M Scalone
- Department of Dermatology, Regional University Hospital of Northern Paraná, State University of Londrina, Londrina, Brazil. E-mail:
| | - André Armani
- Department of Discipline of Head and Neck Surgery, Regional University Hospital of Northern Paraná, State University of Londrina, Londrina, Brazil
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Mahajan VK, Raina RK, Singh S, Rashpa RS, Sood A, Chauhan PS, Mehta KS, Rawat R, Sharma V. Case Report: Histoplasmosis in Himachal Pradesh (India): An Emerging Endemic Focus. Am J Trop Med Hyg 2017; 97:1749-1756. [PMID: 29016342 DOI: 10.4269/ajtmh.17-0432] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
We describe four cases of histoplasmosis indigenous to Himachal Pradesh (India) that will be of considerable public health interest. A 48-year-old human immunodeficiency virus (HIV)-negative man with cervical and mediastinal lymphadenopathy, hepatosplenomegaly, adrenal mass, and bone marrow involvement was treated as disseminated tuberculosis without benefit. Progressive disseminated histoplasmosis was diagnosed from the fungus in smears from adrenal mass. Another 37-year-old HIV-positive man was on treatment of suspected pulmonary tuberculosis. He developed numerous erythema nodosum leprosum-like mucocutanous lesions accompanied by fever, generalized lymphadenopathy, and weight loss. Pulmonary histoplasmosis with cutaneous dissemination was diagnosed when skin lesions showed the fungus in smears, histopathology, and mycologic culture. Both were successfully treated with amphotericin B/itraconazole. Third patient, a 46-year-old HIV-negative man, had oropharyngeal lesions, cervical lymphadenopathy, intermittent fever, hepatosplenomegaly, and deteriorating general health. Progressive disseminated oropharyngeal histoplasmosis was diagnosed from the fungus in smears and mycologic cultures from oropharyngeal lesions and cervical lymph node aspirates. He died despite initiating treatment with oral itraconazole. Another 32-year-old man 3 months after roadside trauma developed a large ulcer with exuberant granulation tissue over left thigh without evidence of immunosuppression/systemic involvement. He was treated successfully with surgical excision of ulcer under amphotericin B/itraconazole coverage as primary cutaneous histoplasmosis confirmed pathologically and mycologically. A clinical suspicion remains paramount for early diagnosis of histoplasmosis particularly in a nonendemic area. Most importantly, with such diverse clinical presentation and therapeutic outcome selection of an appropriate and customized treatment schedule is a discretion the treating clinicians need to make.
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Affiliation(s)
- Vikram K Mahajan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Rashmi Kaul Raina
- Department of Pathology, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Suman Singh
- Department of Pathology, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Rattan Sagar Rashpa
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Anuradha Sood
- Department of Microbiology, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Pushpinder S Chauhan
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Karaninder S Mehta
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Ritu Rawat
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
| | - Vikas Sharma
- Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India
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Lise MLZ, Staub HL. Primary cutaneous histoplasmosis in an immunocompromised patient with long-standing rheumatoid arthritis. Rev Assoc Med Bras (1992) 2017; 62:816-817. [PMID: 28001251 DOI: 10.1590/1806-9282.62.09.816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 10/19/2016] [Indexed: 11/21/2022] Open
Affiliation(s)
- Michelle Larissa Zini Lise
- PhD, Dermatologist, Preceptor at Pontifícia Universidade Católica do Rio Grande do Sul (PUC-RS), Porto Alegre, RS, Brazil
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Bhattacharya JB, Rani P, Aggarwal R, Kaushal S. Primary Cutaneous Histoplasmosis Masquerading as Lepromatous Leprosy. J Clin Diagn Res 2017; 11:ED01-ED02. [PMID: 28273974 DOI: 10.7860/jcdr/2017/19676.9145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 10/17/2016] [Indexed: 11/24/2022]
Abstract
Histoplasmosis is a genus of dimorphic fungi having various varieties of which the commonest one causing infection is Histoplasma capsulatum known to cause histoplasmosis. It has a varied disease spectrum ranging from an acute infection to chronic disease especially in lungs, disseminated disease and cutaneous disorder. Histoplasma capsulatum usually causes subclinical infection and serious infections only manifest in immunocompromised patients. Frank cases of infection are seen in pulmonary histoplasmosis. The spores of these organisms are seen to be strongly associated with droppings of birds and bats. A combination of these droppings and some soil types provide for an excellent environment for the proliferation of spores. Pulmonary histoplasmosis and disseminated disease are very common in AIDS patients and are a great cause of morbidity and mortality in these patients. Primary cutaneous histoplasmosis is very rare and occurs due to penetrating injuries. Once diagnosis is made, the lesions respond very well to oral itraconazole, fluconazole or amphotericicn B. We report a rare case of Cutaneous Histoplasmosis (CHP) in a 70-year-old male with complaints of multiple nodules all over his body in a HIV seronegative and otherwise immunocompetent patient.
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Affiliation(s)
| | - Poonam Rani
- Senior Resident, Department of Pathology, Maulana Azad Medical College , New Delhi, India
| | - Radhika Aggarwal
- Junior Resident, Department of Pathology, Maulana Azad Medical College , New Delhi, India
| | - Seema Kaushal
- Associate Professor, Department of Pathology, Maulana Azad Medical College , New Delhi, India
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Minoza A, Zecler J, Miossec C, Quist D, Pierre-François S, Deligny C, Simon S, Aznar C, Desbois N. Cas groupés d’histoplasmoses à Histoplasma capsulatum var. capsulatum à la Martinique : description des cas et enquête environnementale. J Mycol Med 2016; 26:377-384. [DOI: 10.1016/j.mycmed.2016.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 09/11/2016] [Accepted: 09/11/2016] [Indexed: 11/24/2022]
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voss Gonzalez T, Mattos e Dinato SL, Sementilli A, Romiti N, Beltrame PM, Veiga APR. Atypical presentation of histoplasmosis in an immunocompromised patient. An Bras Dermatol 2016; 90:32-5. [PMID: 26312668 PMCID: PMC4540502 DOI: 10.1590/abd1806-4841.20153782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 05/11/2014] [Indexed: 11/24/2022] Open
Abstract
We present a case of disseminated cutaneous histoplasmosis in a male patient, rural
worker, HIV positive for 20 years, with a history of irregular use of antiretroviral
therapy, T cell counts below 50 cells/mm3 and with good response to treatment with
Itraconazole. We highlight importance of skin lesions in clarifying early diagnosis,
since this co-infection often leads patients to death.
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Affiliation(s)
| | | | | | - Ney Romiti
- Centro Universitário Lusíada, Santos, SP, BR
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11
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Paixão M, Miot HA, Avancini J, Belda Júnior W. Primary cutaneous histoplasmosis developed in the penis of an immunocompetent patient. An Bras Dermatol 2015; 90:255-7. [PMID: 25831000 PMCID: PMC4371679 DOI: 10.1590/abd1806-4841.20153224] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 11/12/2013] [Indexed: 11/22/2022] Open
Abstract
A 70-year-old male presenting a 3-month history of genital painless erythematous nodules in the balanopreputial sulcus was referred to our service. Histopathological exam presented a chronic dermatitis with epithelioid granulomas and Grocott staining revealed numerous fungal structures with a suggestive morphology of Histoplasma sp. Cultures evidenced Histoplasma capsulatum var. capsulatum. Treatment with oral itraconazole led to complete remission of lesions.
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Affiliation(s)
| | - Hélio Amante Miot
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Botucatu, SP, Brazil
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Lise MLZ, Godinho RN, Brollo FM, Staub HL. Cutaneous ulcer in an immunosuppressed patient with adult onset Still's disease: primary cutaneous histoplasmosis? An Bras Dermatol 2014; 89:532-4. [PMID: 24937841 PMCID: PMC4056725 DOI: 10.1590/abd1806-4841.20142727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 07/01/2013] [Indexed: 11/21/2022] Open
Abstract
Histoplasmosis is caused by the dimorphic fungus Histoplasma capsulatum.Primary
infection occurs through inhalation of spores from the air. Immunocompetent
individuals are usually asymptomatic, but may develop pulmonary disease.
Immunocompromised patients tend to present systemic histoplasmosis with
cutaneous lesions occurring by secondary invasion. In this case report, we
describe a probable primary cutaneous histoplasmosis (PCH) in a patient with
adult onset Still's disease under immunosuppression.
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Affiliation(s)
| | | | | | - Henrique Luiz Staub
- Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Oikawa F, Carvalho D, Matsuda NM, Yamada AT. Histoplasmosis in the nasal septum without pulmonary involvement in a patient with acquired immunodeficiency syndrome: case report and literature review. SAO PAULO MED J 2010; 128:236-8. [PMID: 21120437 PMCID: PMC10938995 DOI: 10.1590/s1516-31802010000400012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Revised: 06/10/2010] [Accepted: 06/11/2010] [Indexed: 11/22/2022] Open
Abstract
CONTEXT Histoplasmosis is a fungal disease caused by inhaling spores of the fungus Histoplasma capsulatum. The spores can be found in soil contaminated with bird, bat or chicken feces. Histoplasmosis occurs worldwide and is one of the most common pulmonary and systemic mycoses. CASE REPORT We report here the case of a 37-year-old man with acquired immune deficiency syndrome and histoplasmosis in the nasal septum, without pulmonary involvement, that evolved rapidly to disseminated infection, multiple organ failure and death.
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Affiliation(s)
- Fernando Oikawa
- MD. Resident physician, Hospital Municipal de Campo Limpo "Dr. Fernando Mauro Pires da Rocha", São Paulo, SP, Brazil.
| | - Daniela Carvalho
- MD. Resident physician, Hospital Municipal de Campo Limpo "Dr. Fernando Mauro Pires da Rocha", São Paulo, SP, Brazil.
| | - Nilce Mitiko Matsuda
- MD, PhD. Research associate, Department of Surgery and Anatomy, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
| | - Alice Tatsuko Yamada
- MD, PhD. Cardiologist, Instituto do Coração (InCor), Hospital das Clínicas (HC), School of Medicine, Universidade de São Paulo (USP), São Paulo, and Hospital Municipal de Campo Limpo "Dr. Fernando Mauro Pires da Rocha", São Paulo, SP, Brazil.
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