Table 4.
Characteristics of 28 immunocompromised HIV-negative patients diagnosed as having histoplasmosis in Europe.
| Characteristics | No. (%) |
|---|---|
| Median age, years (range) | 59 (6–86) |
| Males | 16 (57.1) |
| Latency interval | 3 months–42 years |
| Geographical area of suspected Histoplasma exposure | |
| Central/South America * | 14 (50.0) |
| Sub-Saharan Africa § | 5 (12.9) |
| Asia ^ | 2 (7.1) |
| Sub-Saharan Africa/Central America ° | 1 (3.6) |
| South America/Asia ** | 1 (3.6) |
| Asia/Central America # | 1 (3.6) |
| Asia (Malaysia)/United States | 1 (3.6) |
| South America (Suriname)/United States | 1 (3.6) |
| Europe (Italy, Spain) | 2 (7.1) |
| Country of diagnosis | |
| France | 8 (28.6) |
| Spain | 6 (21.4) |
| Netherlands | 5 (17.9) |
| Germany | 3 (10.7) |
| United Kingdom | 2 (7.1) |
| Belgium, Italy, Portugal, Sweden | 1 (3.6) |
| Underlying diseases/immunosuppressive treatment | |
| SOT (kidney 2, kidney/liver 1, liver 2, lung 1, NR 1) | 7 (25.0) |
| Autoimmune diseases (4 RA, 1 SLE, 1 dermatomyositis, | 7 (25.0) |
| 1 myasthenia gravis) | |
| Primary immunodeficiency (IgA deficit 1, idiopathic CD4 lymphopenia 2, autoantibodies against IFN-γ 1) | 4 (14.3) |
| Sarcoidosis | |
| Chronic lymphocytic leukaemia | 2 (7.1) |
| Cancer | 2 (7.1) |
| Ulcerative colitis | 2 (7.1) |
| Haemodialysis | 1 (3.6) |
| Steroids | 1 (3.6) |
| 2 (7.1) | |
| Methods of diagnosis | |
| Histology + culture | 8 (28.6) |
| Histology + PCR | 5 (17.8) |
| Histology + culture + PCR | 5 (17.8) |
| Histology | 4 (14.3) |
| Culture | 3 (10.7) |
| Culture + PCR | 1 (3.6) |
| Autopsy | 2 (7.1) |
| Histoplasma species | |
| H. capsulatum | 25 (89.3) |
| H. duboisii | 2 (7.1) |
| Histoplasma spp. | 1 (3.6) |
| Treatment | |
| d-AMB, itraconazole | 5 (19.2) |
| L-AMB, itraconazole | 5 (19.2) |
| Itraconazole | 5 (19.2) |
| L-AMB | 3 (11.5) |
| ABLC, itraconazole | 1 (3.8) |
| L-AMB, posaconazole | 1 (3.8) |
| Voriconazole, itraconazole | 1 (3.8) |
| Fluconazole, micafungin, L-AMB | 1 (3.8) |
| Fluconazole | 1 (3.8) |
| Not treated | 1 |
| Not reported | 1 |
| Outcome | |
| Survived | 17 (68.0) |
| Died | 8 (32.0) |
| Not reported | 3 |
* 3 Ecuador, Suriname; 2 Brazil; 1 French Guiana, Mexico, Venezuela, Nicaragua, Costa Rica; 2 country not reported. § 1 Guinea Bissau; 2 country not reported; 2 multiple countries. ° Cuba, Cameroon, Chad. ** Suriname, Thailand, Malaysia. # Thailand, Costa Rica. ^ 1 Thailand, Bangladesh. SOT—solid organ transplantation; NR—not reported; RA—rheumatoid arthritis; SLE—systemic lupus erythematosus; d-AMB—deoxycholate amphotericin B; L-AMB—liposomal amphotericin B; ABLC—amphotericin B lipid complex.