García-Vázquez Elisa, Velasco María, Gascón Joaquín, Corachán Manuel, Mejías Teresa, Torres-Rodríguez José Manuel
Servicio de Medicina Tropical, Hospital Clínic i Provincial de Barcelona, Spain.
Enferm Infecc Microbiol Clin. 2005 May;23(5):274-6. doi: 10.1157/13074968.
To analyze the epidemiological and clinical characteristics of Histoplasma capsulatum infection in a group of volunteers who had traveled to Guatemala.
A review was performed of the clinical records of nine patients who consulted at the Tropical Medicine Outpatient Unit of Hospital Clinic in Barcelona, Spain. RESULTS. All patients were attended for travelers' diarrhea. In addition, one student had also presented with respiratory symptoms and fever while in Guatemala and her chest X-ray showed interstitial infiltrates. The epidemiological history recognized risk factors for histoplasmosis in all patients (all of them had been working in the reconstruction of an old school building). The intradermal histoplasmin test was performed and was positive in all nine patients. None of the students required treatment.
Histoplasmosis should be included in the differential diagnosis of returning travelers' fever. The diagnosis would have been missed in all of our patients if not for a directed clinical history taking. It is important to reinforce prevention measures, e.g. the use of face masks, when working in an environment with a risk for acquiring histoplasmosis.
分析一组前往危地马拉旅行的志愿者中荚膜组织胞浆菌感染的流行病学和临床特征。
对在西班牙巴塞罗那临床医院热带医学门诊就诊的9例患者的临床记录进行回顾。结果。所有患者均因旅行者腹泻就诊。此外,一名学生在危地马拉期间还出现了呼吸道症状和发热,其胸部X线显示间质浸润。流行病学史显示所有患者均有组织胞浆菌病的危险因素(他们都曾参与一座旧校舍的重建工作)。进行了皮内组织胞浆菌素试验,9例患者均呈阳性。这些学生均无需治疗。
组织胞浆菌病应列入归国旅行者发热的鉴别诊断。若不是通过有针对性的临床病史采集,我们所有患者的诊断都会被漏诊。在有感染组织胞浆菌病风险的环境中工作时,加强预防措施,如使用口罩,非常重要。