a The University of Manchester and the Manchester Academic Health Service Centre , Manchester , UK.
b Faculty of Medicine, Universitas Indonesia , Jakarta , Indonesia.
Emerg Microbes Infect. 2019;8(1):1139-1145. doi: 10.1080/22221751.2019.1644539.
Histoplasmosis caused by the fungus is often lethal in patients with AIDS. Urine antigen testing is highly sensitive and much quicker for diagnosis than culture. Histoplasmosis has a patchy and incompletely appreciated distribution around the world especially in South East Asia. We conducted a systematic literature review of cases of all disease forms of histoplasmosis in SE Asia, not including the Indian sub-continent. We also reviewed all histoplasmin skin test mapping studies to determine localities of exposure. We found a total of 407 cases contracted or likely to have been contracted in SE Asia. Numbers of cases by country varied: Thailand (233), Malaysia (76), Indonesia (48) and Singapore (21), with few or no cases reported in other countries. Most cases (255 (63%)) were disseminated histoplasmosis and 177 (43%) cases were HIV associated. Areas of high histoplasmin skin test sensitivity prevalence were found in Myanmar, the Philippines, Indonesia, Thailand and Vietnam - 86.4%, 26.0%, 63.6%, 36.0% and 33.7%, respectively. We have drawn maps of these data. Further study is required to ascertain the extent of histoplasmosis within SE Asia. Diagnostic capability for patients with HIV infection is urgently required in SE Asia, to reduce mortality and mis-diagnosis as tuberculosis.
组织胞浆菌病由真菌引起，在艾滋病患者中通常是致命的。尿抗原检测比培养更敏感、更快，有助于诊断。组织胞浆菌病在世界各地的分布呈斑片状且不完全被认识，特别是在东南亚。我们对东南亚所有组织胞浆菌病疾病形式的病例进行了系统的文献回顾，不包括印度次大陆。我们还回顾了所有组织胞浆菌素皮肤试验绘图研究，以确定暴露的地点。我们共发现了 407 例在东南亚感染或可能感染的病例。各国的病例数量不同：泰国（233 例）、马来西亚（76 例）、印度尼西亚（48 例）和新加坡（21 例），其他国家报告的病例很少或没有。大多数病例（255 例（63%））为播散性组织胞浆菌病，177 例（43%）与 HIV 相关。在缅甸、菲律宾、印度尼西亚、泰国和越南，组织胞浆菌素皮肤试验敏感性高的地区，其阳性率分别为 86.4%、26.0%、63.6%、36.0%和 33.7%。我们绘制了这些数据的地图。需要进一步研究以确定东南亚组织胞浆菌病的范围。迫切需要在东南亚提高对 HIV 感染者的诊断能力，以降低死亡率和误诊为结核病。
