Table 2.
Characteristic | No. (%) |
---|---|
Median age, years (range) | 37 (2–63) |
Males | 73 (64) |
Previously known HIV infection | 37 (32.4) |
Histoplasmosis indicating HIV infection | 40 (35.1) |
Time of HIV diagnosis unknown | 37 (32.4) |
Median latency, months (range) | 66 (1–420) |
Median CD4+ cells/μL | 17 (0–594) |
Area of suspected Histoplasma exposure | |
Central/South America § | 55 (50) |
Sub-Saharan Africa ^ | 47 (42.7) |
Asia # | 6 (5.5) |
United States/Mexico | 1 (0.9) |
Europe | 1 (0.9) |
Not reported | 4 (3.5) |
Country of diagnosis | |
Spain | 56 (49.1) |
France | 22 (19.3) |
Italy | 14 (12.3) |
Switzerland, The Netherlands | 6 (5.2) |
United Kingdom | 4 (3.5) |
Portugal | 2 (1.7) |
Belgium, Denmark, Finland, Germany | 1 (0.9) |
Histoplasma species | |
H. capsulatum | 80 (70.2) |
H. duboisii | 20 (17.5) |
Histoplasma spp. | 14 (12.3) |
Concomitant infections/neoplasia | 33 (28.9) |
Fungal | |
Oral candidiasis | 8 (24.4) |
Oesophageal candidiasis | 2 (6.1) |
PJP | 5 (15.1) |
Cryptococcosis | 2 (6.1) |
Coccidioidomycosis | 1 (3.0) |
Bacterial | |
Tuberculosis | 2 (6.1) |
MAC | 3 (9.1) |
Salmonella bacteremia | 1 (3.0) |
Protozoal | |
Chagas disease | 1 (3.0) |
Isopsoriasis | 1 (3.0) |
Helminthic | |
Strongyloides stercoralis | 3 (9.1) |
Neoplasia | |
Kaposi’s sarcoma | 3 (9.1) |
Multiple | 8 (7.0) |
Methods of diagnosis | |
Histology + culture | 32 (28.1) |
Culture + PCR | 19 (16.7) |
Histology | 16 (14.0) |
Culture | 14 (12.3) |
Histology + PCR | 13 (11.4) |
Histology + culture + PCR | 7 (6.1) |
Histology + culture + blood smear | 5 (4.4) |
Histology + PCR | 2 (1.7) |
PCR | 3 (2.6) |
Histology + PCR + blood smear | 1 (0.9) |
Autopsy | 2 (1.7) |
Treatment | |
L-AMB, itraconazole | 30 (38) |
d-AMB, itraconazole | 12 (15.2) |
Itraconazole | 14 (12.7) |
L-AMB | 8 (10.1) |
L-AMB, voriconazole or posaconazole | 3 (3.8) |
ABLC, itraconazole, fluconazole | 3 (3.8) |
Fluconazole | 3 (3.8) |
ABLC | 2 (2.5) |
d-AMB | 2 (2.5) |
Not treated | 2 (2.5) |
Not reported | 35 |
Outcome | |
Survived | 60 (75.9) |
Died | 19 (24.1) |
Not reported | 35 |
* Including our case report. PJP: Pneumocystis jirovecii pneumonia; MAC: Mycobacterium avium-intracellulare; PCR—polymerase chain reaction; L-AMB—liposomal amphotericin B; d-AMB—deoxycholate amphotericin B; ABLC—amphotericin B lipid complex. § 16 Ecuador; 7 Colombia; 5 Brazil; 3 French Guiana, Bolivia, Peru, Suriname; 2 Venezuela, Paraguay; 1 Cuba, Haiti, Martinique, Trinidad and Tobago, Nicaragua, Panama, Dutch Antilles. ^ 9 Ghana; 7 Ivory Coast; 5 Cameroon; 4 Senegal, Nigeria; 3 Democratic Republic of Congo, Congo; 2 Equatorial Guinea, Liberia; 1 Togo, Tanzania, Guinea–Conakry. # 2 Cambodia, Thailand; 1 Malaysia.