Department of Respiratory Diseases, CHU of Martinique, Route de Chateauboeuf, 97200, Fort-de-France, France.
Department of Infectious Diseases, CHU of Martinique, Fort-de-France, France.
BMC Pulm Med. 2023 Mar 22;23(1):95. doi: 10.1186/s12890-023-02388-6.
Histoplasmosis is a fungal disease caused by Histoplasma capsulatum. Histoplasma capsulatum var capsulatum is found in Martinique. Cluster cases following working in deserted house, have been described in Martinique. Cases of acute pulmonary histoplasmosis have been described in immunosuppressed individuals, or in case of substantial exposure to reservoirs of Histoplasma capsulatum; however, cases of acute histoplasmosis are rare in immunocompetent individuals.
We report a series of 4 cases of sporadic acute pulmonary histoplasmosis in immunocompetent subjects. Investigation revealed definite exposure in one patient and 3 cases with potential exposure. The diagnosis was microbiological and histological in 3 patients and histological in one patient. All subjects had positive serology to histoplasmosis. Pulmonary involvement was in the form of nodules and micronodules in 3 cases and ground glass lesions in one case. Patients were treated with itraconazole for 3 months and all had a favourable outcome.
We report a series of 4 cases of acute pulmonary histoplasmosis in immunocompetent individuals, occurring in a context where exposure was uncertain. This raises the problem of occult exposure in the Caribbean. Interventions to raise awareness and encourage caution are warranted targeting the population of the French West Indies and French Guiana.
组织胞浆菌病是由荚膜组织胞浆菌引起的真菌病。荚膜组织胞浆菌荚膜变种仅见于马提尼克岛。在废弃房屋中工作后发生的聚集性病例已在马提尼克岛被描述。在免疫抑制个体或大量接触荚膜组织胞浆菌储库的情况下，会发生急性肺组织胞浆菌病；然而，免疫功能正常的个体中急性组织胞浆菌病很少见。
我们报告了 4 例免疫功能正常的散发性急性肺组织胞浆菌病患者。调查显示，1 例患者有明确的暴露史，3 例患者有潜在暴露史。3 例患者的诊断为微生物学和组织学，1 例患者的诊断为组织学。所有患者的组织胞浆菌血清学均为阳性。3 例患者为结节和微结节，1 例患者为磨玻璃病变。所有患者均接受伊曲康唑治疗 3 个月，均取得良好的结局。
我们报告了 4 例免疫功能正常的急性肺组织胞浆菌病患者，其发生在暴露情况不确定的情况下。这提出了在加勒比地区存在隐匿性暴露的问题。有必要针对法属西印度群岛和法属圭亚那的人群开展提高认识和谨慎行事的干预措施。
