Unis Gisela, Oliveira Flávio de Mattos, Severo Luiz Carlos
Programa de Pós-graduação em Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, RS.
Rev Soc Bras Med Trop. 2004 Nov-Dec;37(6):463-8. doi: 10.1590/s0037-86822004000600007.
This report describes epidemiological, clinical and laboratorial aspects of 111 cases of disseminated histoplasmosis from Rio Grande do Sul over a 25-year period (1977-2002). AIDS and non-AIDS patients were analyzed was the predisposing disease in 63.1% of the patients. In both groups there were mostly men, without evidence of exposure to microfoci contaminated with Histoplasma capsulatum. The main clinical features were systemic (fever and weight loss were present in 97.1 and 92.7% of AIDS and non-AIDS cases), followed by respiratory and mucocutaneous manifestations. Seromycology (positive in 54.5% and 65.3% in AIDS and non-AIDS cases) was useful as a screening test. The high index of cutaneous involvement in AIDS patients (44.3%) compared with North American reports (p <0.01) suggests that different strains of Histoplasma capsulatum may induce different clinical manifestations of the same disease.
本报告描述了南里奥格兰德州25年期间(1977 - 2002年)111例播散性组织胞浆菌病的流行病学、临床和实验室特征。对艾滋病患者和非艾滋病患者进行了分析,63.1%的患者存在易感疾病。两组中男性居多,无接触荚膜组织胞浆菌污染微病灶的证据。主要临床特征为全身性(艾滋病患者和非艾滋病患者中发热和体重减轻分别占97.1%和92.7%),其次是呼吸道和皮肤黏膜表现。血清真菌学检查(艾滋病患者和非艾滋病患者中阳性率分别为54.5%和65.3%)作为筛查试验很有用。与北美报告相比,艾滋病患者皮肤受累率较高(44.3%)(p <0.01),这表明不同的荚膜组织胞浆菌菌株可能导致同一种疾病的不同临床表现。