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

The Fight against HIV-Associated Disseminated Histoplasmosis in the Americas: Unfolding the Different Stories of Four Centers

Centre d’Investigation Clinique Antilles Guyane, Inserm CIC1424, Centre Hospitalier de Cayenne, Cayenne, French Guiana
EA3593 Ecosystèmes Amazoniens et Pathologie Tropicale (EPaT), Université de Guyane, DFR Santé, 97300 Cayenne, French Guiana
Departamento de Doenças Infecciosas, Universidade Federal do Ceará, Fortaleza, 60020-181 Ceará, Brasil
Studies in Translational Microbiology and Emerging Diseases (MICROS) Research Group, School of Medicine and Health Sciences, Universidad del Rosario, 110111 Bogota, Colombia
Service de Dermatologie Vénéréologie, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
Centre d'Investigation Clinique Epidémiologie Clinique Antilles Guyane CIC INSERM 1424, Cayenne General Hospital, Cayenne, French Guiana
Laboratoire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, 97300 Cayenne, French Guiana
Asociación de Salud Integral & Hospital General San Juan de Dios, 01001 Guatemala City, Guatemala, [email protected]
La Clinica Familiar de Luis Angel Garcia, 01001 Guatemala City, Guatemala
Corporacion para Investigaciones Biologicas, Hospital Pablo Tobon Uribe, 11001 Medellin, Colombia
Author to whom correspondence should be addressed.
J. Fungi 2019, 5(2), 51;
Received: 14 May 2019 / Revised: 13 June 2019 / Accepted: 14 June 2019 / Published: 17 June 2019
(This article belongs to the Special Issue Histoplasma and Histoplasmosis)
Disseminated histoplasmosis is a major opportunistic infection of HIV-infected patients, killing thousands in Latin America each year. Yet, it remains a neglected disease that is often confused with tuberculosis, for lack of simple, affordable, and rapid diagnostic tools. There is great heterogeneity in the level of histoplasmosis awareness. The purpose of this report was to describe how the historical “awakening” to the threat of histoplasmosis came to be in four different centers that have actively described this disease: In Brazil, the Sao José hospital in Fortaleza; in Colombia, the Corporación para Investigaciones Biológicas in Medellin; in French Guiana, Cayenne Hospital; and in Guatemala, the Association de Salud Integral in Guatemala city. In Brazil and French Guiana, the search for leishmaniasis on the buffy coat or skin smears, respectively, led to the rapid realization that HIV patients were suffering from disseminated histoplasmosis. With time and progress in fungal culture, the magnitude of this problem turned it into a local priority. In Colombia and Guatemala, the story is different because for these mycology centers, it was no surprise to find histoplasmosis in HIV patients. In addition, collaborations with the CDC to evaluate antigen-detection tests resulted in researchers and clinicians developing the capacity to rapidly screen most patients and to demonstrate the very high burden of disease in these countries. While the lack of awareness is still a major problem, it is instructive to review the ways through which different centers became histoplasmosis-aware. Nevertheless, as new rapid diagnostic tools are becoming available, their implementation throughout Latin America should rapidly raise the level of awareness in order to reduce the burden of histoplasmosis deaths. View Full-Text
Keywords: histoplasmosis; awareness; HIV; Latin America; leishmaniasis histoplasmosis; awareness; HIV; Latin America; leishmaniasis
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Nacher, M.; Leitao, T.S.; Gómez, B.L.; Couppié, P.; Adenis, A.; Damasceno, L.; Demar, M.; Samayoa, B.; Cáceres, D.H.; Pradinaud, R.; Sousa, A.Q.; Arathoon, E.; Restrepo, A. The Fight against HIV-Associated Disseminated Histoplasmosis in the Americas: Unfolding the Different Stories of Four Centers. J. Fungi 2019, 5, 51.

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