PMID- 21199139
OWN - NLM
STAT- MEDLINE
DCOM- 20110228
LR  - 20110104
IS  - 1708-8305 (Electronic)
IS  - 1195-1982 (Linking)
VI  - 18
IP  - 1
DP  - 2011 Jan-Feb
TI  - Histoplasmosis and paracoccidioidomycosis in a non-endemic area: a review of 
      cases and diagnosis.
PG  - 26-33
LID - 10.1111/j.1708-8305.2010.00477.x [doi]
AB  - BACKGROUND: Histoplasmosis and paracoccidioidomycosis (PCM) have increased in 
      Spain in recent years, due firstly to the migration from endemic regions and 
      secondly to travelers returning from these regions. In non-endemic areas, 
      diagnosis of both diseases is hampered by the lack of experience, long silent 
      periods, and the resemblance to other diseases such as tuberculosis and 
      sarcoidosis. METHODS: A total of 39 cases of imported histoplasmosis and 6 cases 
      of PCM diagnosed in the Spanish Mycology Reference Laboratory since 2006 were 
      analyzed. Microbiological diagnosis was performed using classical methods and 
      also a specific real-time polymerase chain reaction (RT-PCR) assay for each 
      microorganism. RESULTS: We had 9 cases of probable histoplasmosis in travelers 
      and 30 cases in immigrants, 29 of whom were defined as proven. 
      Paracoccidioidomycosis (PCM) cases were either immigrants or people who had lived 
      for a long period of time in endemic regions, all of whom were classified as 
      proven cases. Cultures showed a good sensitivity in detecting Histoplasma 
      capsulatum in immigrants with proven histoplasmosis (73%); however, growth was 
      very slow. The fungus was never recovered in traveler patients. Paracoccidioides 
      brasiliensis was isolated in a culture only in one case of the proven PCM. 
      Serological methods were not very reliable in immunocompromised patients with 
      histoplasmosis (40%). A PCR-based technique for histoplasmosis detected 55.5% of 
      the cases in travelers (probable cases) and 89% of the cases in immigrants 
      (proven). The PCR method for PCM detected 100% of the cases. CONCLUSIONS: These 
      kinds of mycoses are increasingly frequent in non-endemic areas, and newer and 
      faster techniques should be used to reach an early diagnosis. The RT-PCR 
      techniques developed appear to be sensitive, specific, and fast and could be 
      helpful to detect those mycoses. However, it is also essential that physicians 
      perform differential diagnosis in individuals coming from endemic areas.
CI  - (c) 2010 International Society of Travel Medicine.
FAU - Buitrago, Maria J
AU  - Buitrago MJ
AD  - Servicio de Micologia, Instituto de Salud Carlos III, Carretera 
      Majadahonda-Pozuelo Km 2, Majadahonda, Madrid, Spain. buitrago@isciii.es
FAU - Bernal-Martinez, Leticia
AU  - Bernal-Martinez L
FAU - Castelli, Maria V
AU  - Castelli MV
FAU - Rodriguez-Tudela, Juan L
AU  - Rodriguez-Tudela JL
FAU - Cuenca-Estrella, Manuel
AU  - Cuenca-Estrella M
LA  - eng
PT  - Journal Article
DEP - 20101128
PL  - England
TA  - J Travel Med
JT  - Journal of travel medicine
JID - 9434456
RN  - 0 (Antifungal Agents)
SB  - IM
MH  - Adult
MH  - Africa
MH  - Antifungal Agents/administration & dosage
MH  - Central America
MH  - Emigration and Immigration/*statistics & numerical data
MH  - Endemic Diseases
MH  - Female
MH  - Histoplasma/*isolation & purification
MH  - Histoplasmosis/*diagnosis/drug therapy/epidemiology/genetics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Paracoccidioides/*isolation & purification
MH  - Paracoccidioidomycosis/*diagnosis/drug therapy/epidemiology/genetics
MH  - Reverse Transcriptase Polymerase Chain Reaction
MH  - Sensitivity and Specificity
MH  - South America
MH  - Spain/epidemiology
MH  - Travel/*statistics & numerical data
MH  - Young Adult
EDAT- 2011/01/05 06:00
MHDA- 2011/03/01 06:00
CRDT- 2011/01/05 06:00
PHST- 2011/01/05 06:00 [entrez]
PHST- 2011/01/05 06:00 [pubmed]
PHST- 2011/03/01 06:00 [medline]
AID - 10.1111/j.1708-8305.2010.00477.x [doi]
PST - ppublish
SO  - J Travel Med. 2011 Jan-Feb;18(1):26-33. doi: 10.1111/j.1708-8305.2010.00477.x. 
      Epub 2010 Nov 28.