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Open AccessArticle

Accuracy of Buffy Coat in the Diagnosis of Disseminated Histoplasmosis in AIDS-Patients in an Endemic Area of Brazil

1
Departamento de Saúde Comunitária, Faculdade de Medicina, Universidade Federal do Ceará, Rodolfo Téofilo, Fortaleza, Ceará 60430-160, Brasil
2
Hospital São José de Doenças Infecciosas, Parquelândia, Fortaleza, Ceará 60455-610, Brasil
3
Centre d’Investigation Clinique 1424 Antilles-Guyane, Inserm, Centre Hospitalier de Cayenne, 97 300 Cayenne, France
4
Faculdade de Medicina, Centro Universitário Unichristus, Cocó, Fortaleza, Ceará 60190-060, Brasil
*
Author to whom correspondence should be addressed.
J. Fungi 2019, 5(2), 47; https://doi.org/10.3390/jof5020047
Received: 1 May 2019 / Revised: 28 May 2019 / Accepted: 31 May 2019 / Published: 9 June 2019
(This article belongs to the Special Issue Histoplasma and Histoplasmosis)
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PDF [248 KB, uploaded 9 June 2019]
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Abstract

The buffy coat is obtained routinely for disseminated histoplamosis (DH) diagnosis in Ceará, Brazil. The aim of this study is to describe the accuracy of staining smears for Histoplasma in the buffy coat of AIDS-patients with DH. From 2012–2013, all results of stained buffy coat smears and culture for fungi performed at São José Hospital were recorded. In total, 489 buffy coats of 361 patients were studied; 19/361 (5.3%; 95%CI = 2.9–7.6%) had positive direct examination stained smears for Histoplasma and 61/361 (16.9%; 95%CI = 13.0–20.8%) had growth in culture. For those with positive Histoplasma cultures, the CD4 count was significantly lower (139.3 vs. 191.7cells/µL; p = 0.014) than others, and death was 18%. The sensitivity and specificity of stained smears was 25.9% and 100%, respectively. A second test, performed up to 36 days from the first one, increased the sensitivity of stained smears to 32.2%. Stained smears of buffy coat have low accuracy; nonetheless, they are easy to perform and can give a quick diagnosis in low-resource endemic areas. Despite the decrease in mortality, it is not yet to the low levels observed in areas that have better and more efficient methods. View Full-Text
Keywords: buffy coat; diagnosis; histoplasmosis; AIDS buffy coat; diagnosis; histoplasmosis; AIDS
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Leitão, T.M.J.S.; Oliveira Filho, A.M.P.; Sousa Filho, J.E.P.; Tavares, B.M.; Mesquita, J.R.L.; Farias, L.A.B.G.; Mota, R.S.; Nacher, M.; Damasceno, L.S. Accuracy of Buffy Coat in the Diagnosis of Disseminated Histoplasmosis in AIDS-Patients in an Endemic Area of Brazil. J. Fungi 2019, 5, 47.

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