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Imported histoplasmosis: two distinct profiles in travelers and immigrants.
J Travel Med. 2009 Jul-Aug; 16(4):258-62.JT

Abstract

BACKGROUND

Histoplasmosis is acquiring importance in nonendemic areas due to the increase in travel and immigration, being the most common systemic mycosis acquired by European travelers. Epidemiological studies show that the incidence of Histoplasma infection in these patients may be higher than previously believed and a wide clinical spectrum of disease may be observed.

METHODS

Cases of histoplasmosis diagnosed at a Tropical Medicine Referral Unit in Madrid, Spain, during the period January 1996 to December 2006 were reviewed.

RESULTS

Ten cases of histoplasmosis in travelers and immigrants are described. Five HIV-positive patients (four immigrants and one expatriate) all presented with progressive disseminated disease. Five HIV-negative patients (travelers) all presented with pulmonary disease: four with an acute pulmonary form (one with pleural involvement) and one patient was found to have residual pulmonary disease (lung nodule). Three of the travelers also had rheumatologic manifestations (arthromyalgias or arthritis).

CONCLUSIONS

Clinicians in nonendemic areas may be faced with patients with a diagnosis of histoplasmosis and although Histoplasma infection can have a varied and nonspecific clinical presentation, imported histoplasmosis may have two distinct profiles. Previously, healthy travelers may be exposed in endemic areas and mainly develop acute forms of the disease with a favorable outcome. Immigrants or expatriates from endemic areas who may be immunosuppressed due to HIV infection may experience reactivation of latent disease developing disseminated forms with high mortality rates. This infection should be considered in the differential diagnosis of diseases affecting travelers and immigrants.

Authors+Show Affiliations

Tropical Medicine and Clinical Parasitology, Infectious Diseases Department, Ramón y Cajal Hospital, Madrid 28034, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19674266

Citation

Norman, Francesca F., et al. "Imported Histoplasmosis: Two Distinct Profiles in Travelers and Immigrants." Journal of Travel Medicine, vol. 16, no. 4, 2009, pp. 258-62.
Norman FF, Martín-Dávila P, Fortún J, et al. Imported histoplasmosis: two distinct profiles in travelers and immigrants. J Travel Med. 2009;16(4):258-62.
Norman, F. F., Martín-Dávila, P., Fortún, J., Dronda, F., Quereda, C., Sánchez-Sousa, A., & López-Vélez, R. (2009). Imported histoplasmosis: two distinct profiles in travelers and immigrants. Journal of Travel Medicine, 16(4), 258-62. https://doi.org/10.1111/j.1708-8305.2009.00311.x
Norman FF, et al. Imported Histoplasmosis: Two Distinct Profiles in Travelers and Immigrants. J Travel Med. 2009 Jul-Aug;16(4):258-62. PubMed PMID: 19674266.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Imported histoplasmosis: two distinct profiles in travelers and immigrants. AU - Norman,Francesca F, AU - Martín-Dávila,Pilar, AU - Fortún,Jesús, AU - Dronda,Fernando, AU - Quereda,Carmen, AU - Sánchez-Sousa,Aurora, AU - López-Vélez,Rogelio, PY - 2009/8/14/entrez PY - 2009/8/14/pubmed PY - 2009/12/16/medline SP - 258 EP - 62 JF - Journal of travel medicine JO - J Travel Med VL - 16 IS - 4 N2 - BACKGROUND: Histoplasmosis is acquiring importance in nonendemic areas due to the increase in travel and immigration, being the most common systemic mycosis acquired by European travelers. Epidemiological studies show that the incidence of Histoplasma infection in these patients may be higher than previously believed and a wide clinical spectrum of disease may be observed. METHODS: Cases of histoplasmosis diagnosed at a Tropical Medicine Referral Unit in Madrid, Spain, during the period January 1996 to December 2006 were reviewed. RESULTS: Ten cases of histoplasmosis in travelers and immigrants are described. Five HIV-positive patients (four immigrants and one expatriate) all presented with progressive disseminated disease. Five HIV-negative patients (travelers) all presented with pulmonary disease: four with an acute pulmonary form (one with pleural involvement) and one patient was found to have residual pulmonary disease (lung nodule). Three of the travelers also had rheumatologic manifestations (arthromyalgias or arthritis). CONCLUSIONS: Clinicians in nonendemic areas may be faced with patients with a diagnosis of histoplasmosis and although Histoplasma infection can have a varied and nonspecific clinical presentation, imported histoplasmosis may have two distinct profiles. Previously, healthy travelers may be exposed in endemic areas and mainly develop acute forms of the disease with a favorable outcome. Immigrants or expatriates from endemic areas who may be immunosuppressed due to HIV infection may experience reactivation of latent disease developing disseminated forms with high mortality rates. This infection should be considered in the differential diagnosis of diseases affecting travelers and immigrants. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/19674266/Imported_histoplasmosis:_two_distinct_profiles_in_travelers_and_immigrants_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1111/j.1708-8305.2009.00311.x DB - PRIME DP - Unbound Medicine ER -