Abstract
The aim of the study presented here was to assess the incidence of histoplasma infection in a cohort of 342 individuals in Spain who had traveled to Latin America for the first time. The histoplasmin skin test was positive in 20% of the travelers, and Central America posed a higher risk for infection than South America (p=0.013). Sleeping outdoors (p=0.031) and the duration of travel (p=0.016) were also identified as significant risk factors. Serological testing demonstrated poor overall sensitivity for detecting infection in the travelers, but for the symptomatic acute cases the results were improved. Histoplasmosis must be considered in patients presenting with fever (odds ratio=3.51 [1.52–8.12]) or cough (odds ratio=4.24 [1.32–13.58]) after visiting Latin America. The results of this study have public health implications and indicate the risks of acquiring histoplasmosis should be included in pre-travel counseling.
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References
Panackal AA, Hajjeh RA, Cetron MS, Warnock DW (2002) Fungal infections among returning travelers. Clin Infect Dis 35:1088–1095
Manfredi R, Mazzoni A, Nanetti A, Chiodo F (1994) Histoplasmosis capsulati and duboisii in Europe: the impact of the HIV pandemic, travel and immigration. Eur J Epidemiol 10:675–681
Garsaud P, Boisseau-Garsaud AM, Desbois N, Verneuil L, Calès-Quist D, Hélénon R, Jouannelle A, Delord JM, Sobesky G, Panelatti G (1999) Epidemiology of histoplasmosis in the French West Indies (Martinique). Trans Roy Soc Trop Med Hyg 93:264–267
Alados JC, Miranda C, Ortiz F, Cano R (1993) Disseminated histoplasmosis in an AIDS patient in Spain. Eur J Clin Microbiol Infect Dis 12:793–794
Gascon J, Torres JM, Luburich P, Ayuso JR, Xaubet A, Corachán M (2000) Imported histoplasmosis in Spain. J Trav Med 7:89–91
Weinberg M, Weeks J, Lance-Parker S, Traeger M, Wiersma S, Phan Q, Dennison D, MacDonald P, Lindsey M, Guarner J, Connolly P, Cetron M, Haijeh R (2003) Severe histoplasmosis in travelers to Nicaragua. Emerg Infect Dis 9:1322–1325
Reiss E, Bragg SL (1988) Immunochemical analysis of histoplasmin proteins and polysaccharide. In: Drouhet E, Cole G, de Repentigny L (eds) Fungal antigens isolation, purification and detection. Plenum, New York pp 417–430
Ouchterlony O, Nilsson L (1978) Immunodiffusion and immunoelectrophoresis. In: Weir DM (ed) Handbook of experimental immunology. Vol. 1. Blackwell Science, Oxford. pp 1–44
Kaufman L, Reiss E (1986) Serodiagnosis of fungal diseases. In: Rose NR, Friedman H, Fahey JL (eds) Manual of clinical laboratory immunology. ASM, Washington DC, pp 446–466
Buxton JA, Dawar M, Wheat LJ, Black WA, Ames NG, Mugford M, Patrick DM (2002) Outbreak of histoplasmosis in a school party that visited a cave in Belize: role of antigen testing in diagnosis. J Trav Med 9:48–50
Deepe GS (2002) Histoplasma capsulatum. In: Mandell GL, Douglas RG, Bennett JE (eds) Enfermedades Infecciosas. Principios y Prácticas. Panamericana, Madrid. pp 3289–3307
Bayés B, Romeu J, Vaquero M, Ribera M, Navarro JT, Rosell A, Sirera G, Clotet B (1996) Histoplasmosis diseminada y sida. Aportación de 4 casos. Med Clin (Barc) 106:700–703
Wheat LJ (1989) Diagnosis and management of histoplasmosis. Eur J Clin Microbiol Infect Dis 8:480–490
Wheat J (2003) Current diagnosis of histoplasmosis. Trends Microbiol 11:488–494
Torres-Rodriguez JM, Ribas-Forcadell E, Gascon J, Espasa M (1999) Diagnostic value of intradermoreaction with histoplasmin in non-endemic areas of histoplasmosis. Med Clin (Barc) 113:37–38
Acknowledgements
The clinical research team acknowledges support provided by Red de Investigación de Centros de Enfermedades Tropicales (RICET) as well as Red de Centros de Investigación Cooperativa en Epidemioilogia y Salud Pública (RCESP) to L.Q. We are grateful to Dr Negroni for providing sera from his laboratory. The study was approved by the ethical committee of University Hospital Barcelona and thus complied with current laws in our country.
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Gascón, J., Torres, J.M., Jiménez, M. et al. Histoplasmosis infection in Spanish travelers to Latin America. Eur J Clin Microbiol Infect Dis 24, 839–841 (2005). https://doi.org/10.1007/s10096-005-0050-6
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DOI: https://doi.org/10.1007/s10096-005-0050-6