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Diagnosis of histoplasmosis in immunosuppressed patients.
Curr Opin Infect Dis. 2008 Aug; 21(4):421-5.CO

Abstract

PURPOSE OF REVIEW

To define the most appropriate studies for making a diagnosis of histoplasmosis in immunosuppressed patients.

RECENT FINDINGS

As is true of all fungal infections in immunosuppressed patients, heightened awareness of the epidemiology and clinical manifestations of histoplasmosis is essential in making an early diagnosis. Increasingly, Histoplasma antigen detection is used to help establish a diagnosis of histoplasmosis. Most of the reported data are on patients with AIDS, but limited data suggest the usefulness of this assay in other immunosuppressed patients as well. False positive reactions occur with other fungal infections, especially blastomycosis, and patients who have histoplasmosis may have a false positive serum Aspergillus galactomannan assay. The identification of the yeast phase of Histoplasma capsulatum in tissue biopsy samples and, uncommonly, in circulating blood phagocytes is also helpful in establishing a diagnosis quickly. PCR techniques have yet to prove useful for the rapid diagnosis of histoplasmosis, and serology is often negative in immunosuppressed patients. Culture remains definitive and should always be performed to confirm the results of the rapid diagnostic studies.

SUMMARY

Rapid techniques, mostly antigen detection in serum and urine and histopathological identification of Histoplasma capsulatum in tissues, are the most important rapid diagnostic tests for histoplasmosis in immunosuppressed patients.

Authors+Show Affiliations

Division of Infectious Diseases, University of Michigan Medical School, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan 48105, USA. ckauff@umich.edu

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18594296

Citation

Kauffman, Carol A.. "Diagnosis of Histoplasmosis in Immunosuppressed Patients." Current Opinion in Infectious Diseases, vol. 21, no. 4, 2008, pp. 421-5.
Kauffman CA. Diagnosis of histoplasmosis in immunosuppressed patients. Curr Opin Infect Dis. 2008;21(4):421-5.
Kauffman, C. A. (2008). Diagnosis of histoplasmosis in immunosuppressed patients. Current Opinion in Infectious Diseases, 21(4), 421-5. https://doi.org/10.1097/QCO.0b013e328306eb8d
Kauffman CA. Diagnosis of Histoplasmosis in Immunosuppressed Patients. Curr Opin Infect Dis. 2008;21(4):421-5. PubMed PMID: 18594296.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diagnosis of histoplasmosis in immunosuppressed patients. A1 - Kauffman,Carol A, PY - 2008/7/3/pubmed PY - 2008/8/13/medline PY - 2008/7/3/entrez SP - 421 EP - 5 JF - Current opinion in infectious diseases JO - Curr Opin Infect Dis VL - 21 IS - 4 N2 - PURPOSE OF REVIEW: To define the most appropriate studies for making a diagnosis of histoplasmosis in immunosuppressed patients. RECENT FINDINGS: As is true of all fungal infections in immunosuppressed patients, heightened awareness of the epidemiology and clinical manifestations of histoplasmosis is essential in making an early diagnosis. Increasingly, Histoplasma antigen detection is used to help establish a diagnosis of histoplasmosis. Most of the reported data are on patients with AIDS, but limited data suggest the usefulness of this assay in other immunosuppressed patients as well. False positive reactions occur with other fungal infections, especially blastomycosis, and patients who have histoplasmosis may have a false positive serum Aspergillus galactomannan assay. The identification of the yeast phase of Histoplasma capsulatum in tissue biopsy samples and, uncommonly, in circulating blood phagocytes is also helpful in establishing a diagnosis quickly. PCR techniques have yet to prove useful for the rapid diagnosis of histoplasmosis, and serology is often negative in immunosuppressed patients. Culture remains definitive and should always be performed to confirm the results of the rapid diagnostic studies. SUMMARY: Rapid techniques, mostly antigen detection in serum and urine and histopathological identification of Histoplasma capsulatum in tissues, are the most important rapid diagnostic tests for histoplasmosis in immunosuppressed patients. SN - 1473-6527 UR - https://www.unboundmedicine.com/medline/citation/18594296/Diagnosis_of_histoplasmosis_in_immunosuppressed_patients_ L2 - https://doi.org/10.1097/QCO.0b013e328306eb8d DB - PRIME DP - Unbound Medicine ER -