Pontes Lícia Borges, Leitão Terezinha do Menino Jesus Silva, Lima Gabrielle Gurgel, Gerhard Emília Santiago, Fernandes Thyago Araújo
Departamento de Infectologia, Hospital São José de Doenças Infecciosas, Universidade Federal do Ceará, Fortaleza, CE.
Rev Soc Bras Med Trop. 2010 Jan-Feb;43(1):27-31. doi: 10.1590/s0037-86822010000100007.
Since the beginning of the HIV epidemic in Ceará, disseminated histoplasmosis (DH) has often been detected among AIDS patients.
In order to investigate the clinical and laboratory characteristics, evolution and survival of cases of DH/AIDS coinfection, the medical records on 134 cases of DH admitted to a reference hospital in Ceará between 1999 and 2005 were analyzed.
Patients with DH presented higher frequency of daily fever, coughing, weight loss, enlarged liver and spleen and acute kidney failure. The diagnosis was made using investigation and/or cultures. At admission, the following were risk factors for death among DH patients: vomiting, dyspnea, respiratory failure, acute kidney failure, hemoglobin < or = 8g/l, urea > or = 40mg/dl and creatinine > or = 1.5 mg/dl.
Patients with DH characteristically presented higher fever, previous hospitalization due to respiratory infection and more clinical complications. Significant anemia and elevated urea were independent risk factors for death among DH patients.
自塞阿拉州出现艾滋病疫情以来，播散性组织胞浆菌病（DH）在艾滋病患者中屡有发现。
为调查DH/艾滋病合并感染病例的临床和实验室特征、病情发展及生存情况，对1999年至2005年间在塞阿拉州一家参考医院收治的134例DH病例的病历进行了分析。
DH患者每日发热、咳嗽、体重减轻、肝脾肿大及急性肾衰竭的发生率较高。通过检查和/或培养进行诊断。入院时，DH患者死亡的危险因素如下：呕吐、呼吸困难、呼吸衰竭、急性肾衰竭、血红蛋白≤8g/l、尿素≥40mg/dl及肌酐≥1.5mg/dl。
DH患者的特点是发热较高、既往因呼吸道感染住院且临床并发症较多。严重贫血和尿素升高是DH患者死亡的独立危险因素。
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