Clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with AIDS who visited a high-complexity hospital in Campo Grande, MS, Brazil
Abstract INTRODUCTION: Disseminated histoplasmosis (DH) is a systemic mycosis caused by Histoplasma capsulatum (H. capsulatum) and is characterized by progressive and fatal evolution in immunocompromised patients. Moreover, it is considered an AIDS-defining disease. METHODS: We performed an observat...
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ftdoajarticles:oai:doaj.org/article:9dfca4c9082740d6b4308d71942d179f 2023-05-15T15:11:44+02:00 Clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with AIDS who visited a high-complexity hospital in Campo Grande, MS, Brazil Barbara Cristina Scarcelli Boigues Anamaria Mello Miranda Paniago Gláucia Moreira Espíndola Lima Maina de Oliveira Nunes Silvia Naomi de Oliveira Uehara https://doi.org/10.1590/0037-8682-0369-2017 https://doaj.org/article/9dfca4c9082740d6b4308d71942d179f EN eng Sociedade Brasileira de Medicina Tropical (SBMT) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000200155&lng=en&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0369-2017 https://doaj.org/article/9dfca4c9082740d6b4308d71942d179f Revista da Sociedade Brasileira de Medicina Tropical, Vol 51, Iss 2, Pp 155-161 Histoplasmosis Histoplasma capsulatum AIDS Arctic medicine. Tropical medicine RC955-962 article ftdoajarticles https://doi.org/10.1590/0037-8682-0369-2017 2022-12-30T21:27:02Z Abstract INTRODUCTION: Disseminated histoplasmosis (DH) is a systemic mycosis caused by Histoplasma capsulatum (H. capsulatum) and is characterized by progressive and fatal evolution in immunocompromised patients. Moreover, it is considered an AIDS-defining disease. METHODS: We performed an observational, analytical, retrospective study to identify the clinical outcomes and risk factors for death from DH in patients with AIDS at an infectious diseases service facility in Brazil between September 2011 and July 2016. Patients with a positive serology for HIV and DH were diagnosed via direct examination and/or positive cultures for H. capsulatum. RESULTS: Twenty-three patients were included in this study. Approximately, 82.6% were men, with a mean age of 41.0±11.5 years, and 52.2% had a concomitant diagnosis of AIDS and DH. The median CD4+ T cell count was 19 cells/mm3, and 56.5% of the patients died. The most frequently observed symptoms were fever, dyspnea, and skin lesions. On the basis of a comparative analysis of those who died and survived, the absence of splenomegaly and hepatomegaly and the presence of H. capsulatum in the peripheral blood were considered as risk factors for death. Those who died had a higher leukocyte count; CRP, urea, and lactate dehydrogenase levels; AST index; and international normalized ratio prothrombin time. The serum total protein and albumin levels of the patients were lower. CONCLUSIONS: The mortality rate for DH is high among severely immunocompromised patients with AIDS. The risk factors for death were those traditionally associated with blood dyscrasia, inflammatory activity, as well as increased renal and nutritional impairment. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Revista da Sociedade Brasileira de Medicina Tropical 51 2 155 161 |
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Directory of Open Access Journals: DOAJ Articles |
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Histoplasmosis Histoplasma capsulatum AIDS Arctic medicine. Tropical medicine RC955-962 |
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Histoplasmosis Histoplasma capsulatum AIDS Arctic medicine. Tropical medicine RC955-962 Barbara Cristina Scarcelli Boigues Anamaria Mello Miranda Paniago Gláucia Moreira Espíndola Lima Maina de Oliveira Nunes Silvia Naomi de Oliveira Uehara Clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with AIDS who visited a high-complexity hospital in Campo Grande, MS, Brazil |
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Histoplasmosis Histoplasma capsulatum AIDS Arctic medicine. Tropical medicine RC955-962 |
description |
Abstract INTRODUCTION: Disseminated histoplasmosis (DH) is a systemic mycosis caused by Histoplasma capsulatum (H. capsulatum) and is characterized by progressive and fatal evolution in immunocompromised patients. Moreover, it is considered an AIDS-defining disease. METHODS: We performed an observational, analytical, retrospective study to identify the clinical outcomes and risk factors for death from DH in patients with AIDS at an infectious diseases service facility in Brazil between September 2011 and July 2016. Patients with a positive serology for HIV and DH were diagnosed via direct examination and/or positive cultures for H. capsulatum. RESULTS: Twenty-three patients were included in this study. Approximately, 82.6% were men, with a mean age of 41.0±11.5 years, and 52.2% had a concomitant diagnosis of AIDS and DH. The median CD4+ T cell count was 19 cells/mm3, and 56.5% of the patients died. The most frequently observed symptoms were fever, dyspnea, and skin lesions. On the basis of a comparative analysis of those who died and survived, the absence of splenomegaly and hepatomegaly and the presence of H. capsulatum in the peripheral blood were considered as risk factors for death. Those who died had a higher leukocyte count; CRP, urea, and lactate dehydrogenase levels; AST index; and international normalized ratio prothrombin time. The serum total protein and albumin levels of the patients were lower. CONCLUSIONS: The mortality rate for DH is high among severely immunocompromised patients with AIDS. The risk factors for death were those traditionally associated with blood dyscrasia, inflammatory activity, as well as increased renal and nutritional impairment. |
format |
Article in Journal/Newspaper |
author |
Barbara Cristina Scarcelli Boigues Anamaria Mello Miranda Paniago Gláucia Moreira Espíndola Lima Maina de Oliveira Nunes Silvia Naomi de Oliveira Uehara |
author_facet |
Barbara Cristina Scarcelli Boigues Anamaria Mello Miranda Paniago Gláucia Moreira Espíndola Lima Maina de Oliveira Nunes Silvia Naomi de Oliveira Uehara |
author_sort |
Barbara Cristina Scarcelli Boigues |
title |
Clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with AIDS who visited a high-complexity hospital in Campo Grande, MS, Brazil |
title_short |
Clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with AIDS who visited a high-complexity hospital in Campo Grande, MS, Brazil |
title_full |
Clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with AIDS who visited a high-complexity hospital in Campo Grande, MS, Brazil |
title_fullStr |
Clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with AIDS who visited a high-complexity hospital in Campo Grande, MS, Brazil |
title_full_unstemmed |
Clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with AIDS who visited a high-complexity hospital in Campo Grande, MS, Brazil |
title_sort |
clinical outcomes and risk factors for death from disseminated histoplasmosis in patients with aids who visited a high-complexity hospital in campo grande, ms, brazil |
publisher |
Sociedade Brasileira de Medicina Tropical (SBMT) |
url |
https://doi.org/10.1590/0037-8682-0369-2017 https://doaj.org/article/9dfca4c9082740d6b4308d71942d179f |
geographic |
Arctic |
geographic_facet |
Arctic |
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Arctic |
genre_facet |
Arctic |
op_source |
Revista da Sociedade Brasileira de Medicina Tropical, Vol 51, Iss 2, Pp 155-161 |
op_relation |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822018000200155&lng=en&tlng=en https://doaj.org/toc/1678-9849 1678-9849 doi:10.1590/0037-8682-0369-2017 https://doaj.org/article/9dfca4c9082740d6b4308d71942d179f |
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https://doi.org/10.1590/0037-8682-0369-2017 |
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Revista da Sociedade Brasileira de Medicina Tropical |
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