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Revista da Sociedade Brasileira de Medicina Tropical
On-line version ISSN 1678-9849
BORGES, Aércio S. et al. Histoplasmose em pacientes imunodeprimidos: estudo de 18 casos observados em Uberlândia, MG. Rev. Soc. Bras. Med. Trop. [online]. 1997, vol.30, n.2, pp. 119-124. ISSN 1678-9849. http://dx.doi.org/10.1590/S0037-86821997000200006.
The authors describe eighteen cases of histoplasmosis in immunodepressed patients, 17 with the acquired immunodeficiency syndrome (AIDS) and one patient with hepatic cirrhosis. The diagnosis of histoplasmosis was made by isolation of Histoplasma capsulatum from cerebrospinal fluid (CSF), blood and bone marrow or by histopathologic (biopsy or post mortem) examination. The mean age of the patients was 35.8 years; 13 patients were male (72.2%). The disease was disseminated, with the following distribution:skin (38.8%), bone marrow (27.7%), nasopharyngeal mucosa (22.2%), lungs (22.2%), cólon (11.1%), central nervous system (5.5%) and esophagus (5.5%). Adenomegaly (50%), hepatomegaly (77.7%) and splenomegaly (61.1%) were frequently seen. The most common hematologic abnormality was pancytopenia (33.3%) of the patients. Eleven patients were treated, 9 with amphotericin B and 2 with itraconazole. Eight had good clinical improvement and all of them were given amphotericin B or a triazolic as maintenance therapy. This study emphasize the importance of this mycosis in imunodepressed patients, specially AIDS patients, in whom the infection tends to invade the macrophagic-lymphoid system and preferentially the cutaneous tegument.
Keywords : Histoplasmosis; AIDS; Immunosupression; Hepatic cirrhosis.