Important note: Information in this article was accurate in 1985. The state of the art may have changed since the publication date.
Histoplasmosis in the acquired immune deficiency syndrome.
Am J Med. 1985 Feb;78(2):203-10. Unique Identifier : AIDSLINE MED/85119298 Wheat LJ; Slama TG; Zeckel ML
Abstract:
This report describes the experience with disseminated histoplasmosis in seven of 15 patients with the acquired immune deficiency syndrome (AIDS) diagnosed in Indianapolis since 1981. Three were homosexual, two were intravenous drug addicts, one was the spouse of another patient with AIDS and disseminated histoplasmosis, and the seventh was a hemophiliac. Six had associated infections: candidiasis in three, Pneumocystis carinii pneumonia, recurrent mucocutaneous herpes simplex infection, and disseminated Mycobacterium avium infection in two each, and disseminated infection with an unidentified mycobacterium in one. Clinical diseases suggested sepsis in four. Histoplasma fungemia occurred in five, but the diagnosis was established first by visualization of organisms in blood or bone marrow in three. Results of Histoplasma serologic tests were positive in each. Three died before receiving 50 mg of amphotericin B, three had prompt improvement with amphotericin B, and one was treated with ketoconazole to prevent dissemination. However, two of the three patients treated with amphotericin B had relapses after a 35 mg/kg course, and the third died within a month following therapy. Disseminated histoplasmosis is a major opportunistic infection in patients with AIDS from endemic areas. AIDS should be strongly considered in otherwise healthy persons with disseminated histoplasmosis, especially if risk factors for AIDS are present. Amphotericin B is not curative in these patients.
Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/DRUG THERAPY/ PHYSIOPATHOLOGY Adult Amphotericin B/THERAPEUTIC USE Candidiasis/DRUG THERAPY/PHYSIOPATHOLOGY Case Report Female Herpes Simplex/PHYSIOPATHOLOGY Histoplasmosis/*COMPLICATIONS/DRUG THERAPY/PHYSIOPATHOLOGY Homosexuality Human Ketoconazole/THERAPEUTIC USE Male Mycobacterium avium Mycobacterium Infections/PHYSIOPATHOLOGY Pneumonia, Pneumocystis carinii/PHYSIOPATHOLOGY Tuberculosis/PHYSIOPATHOLOGY JOURNAL ARTICLE
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Important note: Information in this article was accurate in 1985. The state of the art may have changed since the publication date.
