XI International Meeting on Paracoccidioidomycosis

XI International Meeting on Paracoccidioidomycosis

Resume:127-2

Poster (Painel)

127-2	Early and late evaluation of histoplasmosis in non-AIDS patients.
Authors:	Ricardo de Souza Cavalcante (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Júlio Defaveri (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Kunie Yabuki Rabello Coelho (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP) ; Rinaldo Poncio Mendes (FMB - UNESP - Faculdade de Medicina de Botucatu - UNESP)

Abstract

Introduction. Histoplasmosis-HST is an endemic and systemic mycosis which also affects immunocompromised patients. This study aims to characterize HST in non-AIDS patients at a university hospital. Patients and Methods. A retrospective study of 15 patients attended from 1989 to 2010 was carried out. Histoplasmosis was confirmed by the identification of the etiological agent in the histopathological examination of tissues stained by hematoxylin and eosin and/or Gomori’s methenamine-silver, and/or by the identification of specific serum antibodies by agar gel precipitation test. Results. Histoplasmosis-patients aged from 34 to 88 years (Md=59), 93% males and 7% females. Predisposing conditions could be identified in nine (60%) patients, predominating old-age (six) and malignancies (three). Histopathological examination confirmed the diagnosis of 12 (80%) patients: oral mucous membrane (40%), lungs (33%), skin (20%) and lymph nodes (7%). Weight loss (60%) and anorexia (40%) were the main general complaints. The chronic pulmonary form was observed in 33% of the patients and the chronic disseminated form in 67%. Lungs (47%), oral mucous membrane (33%), lymph nodes (20%), skin (20%), esophagus (13%), and adrenals (7%) were involved. Itraconazole was indicated in the treatment of 12 cases and amphotericin B deoxycholate in the other three. The treatment succeeded in 13 (87%) patients and failed in the other two (13%), who died due to chronic myelogenous leukemia (one case) and bacterial pneumonia (one case), associated to active HST. Conclusions. The importance of the histopathological diagnosis, the predominance of the chronic forms in mildly immunocompromised patients, and the efficacy of itraconazole in the treatment of these histoplasmosis clinical forms were demonstrated.

Keyword: Histoplasmosis, Non-AIDS patients, Clinical and treatment aspects

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