Histoplasmosis in HIV-positive patients in Ceara, Brazil: clinical-laboratory aspects and in vitro antifungal susceptibility of Histoplasma capsulatum isolates

Histoplasmosis in HIV-positive patients in Ceara, Brazil: clinical-laboratory aspects and in vitro antifungal susceptibility of Histoplasma capsulatum isolates

Author Brilhante, Raimunda S. N. Google Scholar
Fechine, Maria A. B. Google Scholar
Mesquita, Jaco R. L. Google Scholar
Cordeiro, Rossana A. Google Scholar
Rocha, Marcos F. G. Google Scholar
Monteiro, Andre J. Google Scholar
Lima, Rita A. C. Google Scholar
Caetano, Erica P. Google Scholar
Pereira, Juliana F. Google Scholar
Castelo-Branco, Debora S. C. M. Google Scholar
Camargo, Zoilo P. Autor UNIFESP Google Scholar
Sidrim, Jose J. C. Google Scholar
Institution Univ Fed Ceara
Univ Estadual Ceara
Hosp Sao Jose
Universidade Federal de São Paulo (UNIFESP)
Abstract This study contains a descriptive analysis of histoplasmosis in AIDS patients between 2006 and 2010 in the state of Ceara, Brazil. Additionally, the in vitro susceptibility of Histoplasma capsulatum isolates obtained during this period was assessed. We report 208 cases of patients with histoplasmosis and AIDS, describing the epidemiological, clinical, laboratory and therapeutic aspects. the in vitro antifungal susceptibility test was carried out by the microdilution method, according to Clinical and Laboratory Standards Institute, with H. capsulatum in the filamentous and yeast phases, against the antifungals amphotericin B, fluconazole, itraconazole, voriconazole and caspofungin. in 38.9% of the cases, histoplasmosis was the first indicator of AIDS and in 85.8% of the patients the CD4 cell count was lower than 100 cells/mm(3). the lactate dehydrogenase levels were high in all the patients evaluated, with impairment of hepatic and renal function and evolution to death in 42.3% of the cases. the in vitro susceptibility profile demonstrated there was no antifungal resistance among the isolates evaluated. There was a significant increase in the number of histoplasmosis cases in HIV-positive patients during the period surveyed in the state of Ceara, northeastern Brazil, but no antifungal resistance among the recovered isolates of H. capsulatum. (C) 2012 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier B.V. All rights reserved.
Keywords Brazil
AIDS
Histoplasmosis
Antifungal susceptibility
Histoplasma capsulatum
Epidemiology
Language English
Sponsor Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
Grant number CNPq: 562296/2010-7
CNPq: 552161/2011-0
CNPq: 304779/2011-3
CAPES: 2103/2009
Date 2012-08-01
Published in Transactions of the Royal Society of Tropical Medicine and Hygiene. New York: Elsevier B.V., v. 106, n. 8, p. 484-488, 2012.
ISSN 0035-9203 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 484-488
Origin http://dx.doi.org/10.1016/j.trstmh.2012.05.003
Access rights Closed access
Type Article
Web of Science ID WOS:000307032700006
URI http://repositorio.unifesp.br/handle/11600/35143

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