Lahuna Constance, Dequidt Tanguy, Postel-Vinay Pierre, Peugny Sandrine, Haboub Marwan, Markowicz Samuel, Nicolas Muriel
Infectious Disease Department, Guadeloupe University Hospital, 97159 Pointe-à Pitre, France.
Intensive Care Unit Department, Guadeloupe University Hospital, 97159 Pointe-à Pitre, France.
J Fungi (Basel). 2025 Jun 18;11(6):462. doi: 10.3390/jof11060462.
is an environmentally acquired dimorphic fungus. Infection results in histoplasmosis, a clinical syndrome often underdiagnosed and that may progress to life-threatening disseminated infection not only in immunocompromised individuals but also, following high-level exposure, in immunocompetent hosts. Epidemiological data from Caribbean regions, and particularly from Guadeloupe, remain limited. We performed a retrospective cohort study of all microbiologically confirmed histoplasmosis cases managed at the University Hospital of Guadeloupe between January 2014 and October 2024. Demographic, clinical, diagnostic, therapeutic, and outcome data were retrieved from medical records and analyzed using descriptive statistics. Forty-two patients met the inclusion criteria, corresponding to an estimated annual incidence rate of 1 per 100,000 inhabitants. The median age was 52 years, and the male-to-female ratio was 4:1. An underlying immunocompromising condition was present in 85% of cases, most commonly HIV infection (48%). Common clinical features included weight loss (97%), fever (89%), and pulmonary manifestations (81%). The mean time to diagnosis from hospital admission was 3.5 ± 10.3 days. Direct microscopy was positive in 67% of cases, and culture was positive in 88% of cases. Intravenous liposomal amphotericin B constituted the initial therapy in 71% of patients. Overall, the in-hospital mortality was 29%, rising to 40% among HIV-positive individuals. The 30-day survival rate was 71%. Histoplasmosis in Guadeloupe is under-recognized and associated with appreciable morbidity and mortality in both immunocompromised and immunocompetent patients. The wider availability of rapid diagnostics and heightened clinical vigilance are essential to shorten diagnostic delays and improve outcomes in this Caribbean population.
是一种通过环境感染的双相真菌。感染会导致组织胞浆菌病，这是一种临床综合征，常常诊断不足，不仅在免疫功能低下的个体中可能进展为危及生命的播散性感染，而且在高暴露水平后，免疫功能正常的宿主中也可能如此。来自加勒比地区，特别是瓜德罗普岛的流行病学数据仍然有限。我们对2014年1月至2024年10月在瓜德罗普大学医院管理的所有微生物学确诊的组织胞浆菌病病例进行了一项回顾性队列研究。从医疗记录中检索人口统计学、临床、诊断、治疗和结局数据，并使用描述性统计进行分析。42名患者符合纳入标准，估计年发病率为每10万居民1例。中位年龄为52岁，男女比例为4:1。85%的病例存在潜在的免疫功能低下状况，最常见的是HIV感染（48%）。常见的临床特征包括体重减轻（97%）、发热（89%）和肺部表现（81%）。从入院到诊断的平均时间为3.5±10.3天。67%的病例直接显微镜检查呈阳性，88%的病例培养呈阳性。71%的患者初始治疗采用静脉注射脂质体两性霉素B。总体而言，住院死亡率为29%，HIV阳性个体中升至40%。30天生存率为71%。瓜德罗普岛的组织胞浆菌病未得到充分认识，在免疫功能低下和免疫功能正常的患者中均与明显的发病率和死亡率相关。更广泛地提供快速诊断方法和提高临床警惕性对于缩短诊断延迟和改善该加勒比人群的结局至关重要。
