Abstract

RUIZ DIAZ, Aldo; VICENTI, Cristina; TABOADA, Aurelia  and  BENITEZ, Gustavo. Presentations of histoplasmosis in AIDS patients. Rev. Inst. Med. Trop. [online]. 2009, vol.4, n.1, pp.28-33. ISSN 1996-3696.

Introduction: histoplasmosis, is a systemic fungal infection endemic in our country, caused by Histoplasma capsulatum. It is the second systemic fungal infection in AIDS patients. It is most often disseminated with fever, loss weight, hepatosplenomegaly with involvement of multiple organs, with lives compromising in the most serious cases. The 90% occur in patients with CD4 <100 cells/mm3. It may be located in different organs. Objective: To characterize the various presentations of histoplasmosis in AIDS patients admitted in the IMT. Design: descriptive, observational, retrospective cross-sectional. Materials and Methods: We studied 28 patients with AIDS and histoplasmosis, during 01/2007 to 06/2009. The variables estudied was: age, sex, origin, presence and evolution of fever and CD4 count, diagnosis methods. The data were loaded into a spreadsheet in Excel (R), and analyzed by Epi Info version 3.5.1 system (R). Results: Of the 28 patients, 19 (67.9%) were males, mean age 29.5 years (22-44). They come from Asunción and Central 14 (50%). The CD4 count was performed in 25 (89.28%) of these 20 ptes 80%) with less than 50, 2 (8%) between 50 and 100, and 2 (8%) between 100 and 150. With fever 21 (75%) (15 (71.42%), prolonged fever). Skin lesions were found in 17 (60.7%) (5 involving oral mucosa and 1 nodal); mucosal lesion 1, mucosal lesion and nodal 1, lymph node 6 (21.42%) (1 Aspirates from Bone Marrow [ABMP] and 1 biopsy [Bx] transbronchial positive) without skin lesions, mucosal or lymph node 3 (10.34%) (2 ABMP and 1 Bx positive duodenal). Of the 15 patients with prolonged fever: 9 (60%) do not presented skin lesion or mucosal (all with pulmonary infiltrates, 4 with splenomegaly, hepatomegaly and 1 with ABMP 3 with positive). 7 (25%) die, all with systemic disease and prolonged fever. The Dx was performed by scarification of skin and/or mucosa, Bx (nodal, duodenal and transbronchial) and ABMP culture-positive (1 with positive blood culture).

Keywords : Histoplasmosis; ABMP; AIDS.

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