Histoplasmosis in India

The article gives a critical review of the available publications pertaining to Histoplasmosis in India. Evidence on hand indicates that this fungus infection is not endemic in India.

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Zusammenfassung Der Artikel gibt einen kritischen Überblick über die verfügbaren Veröffentlichungen, die die Histoplasmose in Indien betreffen. Daraus geht hervor, daß diese Pilzerkrankung in Indien nicht endemisch ist.

     

Antibodies in Histoplasmosis

Production of precipitating and complement-fixing antibody in rabbits and other animals was induced by immunization with live yeast-phase cells of Histoplasma capsulatum. Results of studies of polysaccharide antigens from three strains of H. capsulatum, by quantitative complement-fixation with human and rabbit antisera, strongly suggest the presence of type specificity. The variations of titer during 11 weeks in one patient with histoplasmosis and the variations of titer among a group of patients with histoplasmosis were studied by use of quantitative complement-fixation tests.     

Ocular Histoplasmosis

Case reports of three residents of Ontario with clinical histoplasmic chorioretinitis are presented. The diagnosis was made on the basis of the clinical appearance, the presence of calcified lesions in the chest, a negative skin test to tuberculin, and a positive skin test to toxoplasmin. All patients were treated with intravenous amphotericin B. Except for transitory elevation of blood urea nitrogen, there were no serious complications from the drug and in all cases the lesions in the eyes were improved. Histologic or cultural proof of the presence of fungus in the eye is not available, but clinical and laboratory findings can combine to point to the diagnosis of histoplasmosis. In such cases, since vision is at stake, treatment with amphotericin B should be considered.     

Epidemiology of Histoplasmosis

Purpose of Review

Histoplasma capsulatum is an environmental fungus that contributes significant morbidity and mortality throughout the globe, especially in immunocompromised hosts. This review presents current data on the understanding of histoplasmosis epidemiology, including changing incidence among geographic regions and patient populations with increased risk.

Recent Findings

Global cases are more frequently identified due to the HIV epidemic, an increasing number of immunocompromised patients, and improved diagnostic capabilities. The global distribution of histoplasmosis extends to several countries in Central and South America and the Caribbean, as well as southern and sub-Saharan Africa, India, China, and Southeast Asia. Cases are also seen throughout Europe and non-endemic regions of the USA often due to migration and travelers.

Summary

The changing epidemiology of histoplasmosis underlines the importance of continued surveillance and reporting to better understand the regions which place patients at a higher risk for infection.

     

Histoplasmosis: Epidemiology in Latin America

Histoplasmosis is a frequent health problem in Latin American countries, but the fact that it is not a reportable disease prevents reliable estimates of its real incidence and impact on public health. Epidemiologic and clinical data remain patchy in general, and in some countries the information available is very limited. Histoplasmosis has a significant public health impact in susceptible populations such as immunosuppressed individuals, in whom the disease is associated with poor outcomes. Limited availability of diagnostic tools in many regions of Latin America is an additional problem, as many patients are already severely ill by the time of the diagnosis. Efforts are therefore necessary to ensure early diagnosis and appropriate treatment, limit the severity of the disease manifestations, and reduce morbidity and mortality. This paper reviews important aspects of the epidemiology of histoplasmosis, the most clinically significant endemic mycosis in Latin America.