da Silva Ferreira Bianca, de Araújo Filho Joâo Alves, Matos Pereira Nayara, de Miranda Godoy Lucas, Borges Lamounier Bruna, Dias Nunes Elizon, Espíndola Rosa Lucas
Departamento de Medicina da Universidade Federal do Maranhão, Imperatriz, Brasil.
Instituto de Patologia Tropical e Saúde Pública da Universidade Federal de Goiás, Goiânia, Goiás, Brasil.
Infez Med. 2017 Sep 1;25(3):258-262.
Histoplasmosis is a fungal disease commonly observed as an opportunistic disease in AIDS patients. It is a neglected disease in many countries, particularly Latin America, including Brazil. It is related with environmental factors, even in urban areas, where the incidence has increased. Implementing a descriptive ecological study, we performed a retrospective chart review for data collected between January 2003 and July 2014 for AIDS patients with histoplasmosis who lived in Goiania. The selected cases were georeferenced to analyse the incidence of histoplasmosis in AIDS patients in the metropolitan area of Goiania. In all, 166 patients (130 men) met the criteria for AIDS and histoplasmosis coinfection. Almost half of the patients (41%) had simultaneous histoplasmosis and AIDS diagnoses. The general mortality was 53% (88 patients). The main symptoms involved the respiratory, gastrointestinal, and cutaneous systems. The distribution of cases included almost all regions of the urban areas, with some predominance in the eastern and western regions close to areas of environmental degradation, contaminated water sources and unplanned urbanisation. In conclusion, coinfection with HIV and disseminated histoplasmosis is common and associated with high mortality rates in our referral hospital for infectious diseases. Despite being considered as having a predominantly rural epidemiology, many patients reported living in urban areas such as Goiânia and Aparecida de Goiânia. Our findings suggest the need for environmental studies to evaluate environmental contamination and possible local risk factors for H. capsulatum infection in addition to serological surveys to determine the prevalence of this infection in the studied cities.
组织胞浆菌病是一种真菌病，在艾滋病患者中通常作为机会性疾病出现。在许多国家，尤其是包括巴西在内的拉丁美洲，它是一种被忽视的疾病。它与环境因素有关，即使在发病率有所上升的城市地区也是如此。通过开展一项描述性生态学研究，我们对2003年1月至2014年7月期间居住在戈亚尼亚的患有组织胞浆菌病的艾滋病患者收集的数据进行了回顾性病历审查。将所选病例进行地理定位，以分析戈亚尼亚大都市区艾滋病患者中组织胞浆菌病的发病率。共有166例患者（130名男性）符合艾滋病和组织胞浆菌病合并感染的标准。几乎一半的患者（41%）同时被诊断为患有组织胞浆菌病和艾滋病。总体死亡率为53%（88例患者）。主要症状累及呼吸、胃肠和皮肤系统。病例分布几乎涵盖了市区的所有区域，在靠近环境退化地区、受污染水源和无规划城市化区域的东部和西部地区有一定的优势。总之，在我们这家传染病转诊医院，HIV与播散性组织胞浆菌病合并感染很常见，且与高死亡率相关。尽管该病被认为主要具有农村流行病学特征，但许多患者报告居住在戈亚尼亚和戈亚尼亚的阿帕雷西达等城市地区。我们的研究结果表明，除了进行血清学调查以确定所研究城市中这种感染的患病率外，还需要开展环境研究来评估环境污染以及荚膜组织胞浆菌感染可能的局部危险因素。
