Ferreira Marcelo Simão, Borges Aércio Sebastião
Faculdade de Medicina, Universidade Federal de Uberlândia, Uberlândia, MG.
Rev Soc Bras Med Trop. 2009 Mar-Apr;42(2):192-8. doi: 10.1590/s0037-86822009000200020.
Histoplasmosis is a fungal infection caused by the dimorphic fungus Histoplasma capsulatum. It is classically considered an endemic mycosis, even though the fungus has an opportunistic behavior in immunocompromised patients. People acquired the infection through the inhalation of conidial forms present in the environmental, such as caves dwelling bats and soils inhabited by chickens. The clinical features may vary from asymptomatic infections to disseminated severe forms that affect patients with acquired immunodeficiency syndrome or hematological malignancies and allograft recipients. The diagnosis is based on the detection of the fungus in organic fluids (sputum, blood, liquor) or tissues (histopathological assays), in the culture of biological samples and serological assays. The treatment of severe chronic respiratory acute or localized forms can be performed with oral azolic (itraconazol) and in the disseminated forms, the amphotericin B (preferentially the lipidic formulations) consists in the elected drug to initiate the therapy. Nowadays, histoplasmosis represents one of the most important systemic mycosis in the Americas, with broad distribution in all regions of Brazil.
组织胞浆菌病是一种由双相真菌荚膜组织胞浆菌引起的真菌感染。尽管该真菌在免疫功能低下的患者中具有机会性感染行为，但传统上它被认为是一种地方性真菌病。人们通过吸入环境中存在的分生孢子形式而感染，比如洞穴中的蝙蝠和鸡栖息的土壤中的分生孢子。其临床特征从无症状感染到播散性严重形式不等，后者会影响获得性免疫缺陷综合征患者、血液系统恶性肿瘤患者和同种异体移植受者。诊断基于在有机液体（痰液、血液、脑脊液）或组织（组织病理学检测）中检测到真菌、生物样本培养以及血清学检测。严重慢性呼吸道急性或局限性形式的治疗可采用口服唑类药物（伊曲康唑），对于播散性形式，两性霉素B（优先选用脂质制剂）是开始治疗的首选药物。如今，组织胞浆菌病是美洲最重要的系统性真菌病之一，在巴西所有地区广泛分布。
