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THE “HISTOPLASMOSIS PORTO ALEGRE MANIFESTO” - ADDRESSING DISSEMINATED HISTOPLASMOSIS IN AIDS
Global fungal disease
Genus Histoplasma
Systemic endemic mycoses
Immunocompromised patients
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Abstract
Histoplasmosis is a global fungal disease that has a high prevalence especially in the Americas caused by diverse species nested within the genus Histoplasma [1]. Other parts of the world where it has been identified include Southern Europe, Africa, and Asia [2]. In Latin America, histoplasmosis is the most prevalent systemic endemic mycoses [3]. The disease is associated with a wide plethora of clinical manifestations, including disseminated histoplasmosis (DH) in immunocompromised patients, chronic pulmonary disease, pulmonary nodules, mediastinal adenitis, fibrosing mediastinitis, chorioretinitis, and acute pulmonary disease. For many of these conditions, the differential diagnosis with tuberculosis is challenging. Risk populations for DH include people living with HIV/AIDS (PLWHA) and other immunocompromising conditions, like transplant recipients, and extremes of age and the use of immunosuppressive medicines, like the use of steroids and TNF-α inhibitors [4]. Reported cases certainly underestimate the actual burden of histoplasmosis, since in most places, Histoplasma antigen detection was not available, and many states did not report the occurrence of cases.
Keywords
HistoplasmosisGlobal fungal disease
Genus Histoplasma
Systemic endemic mycoses
Immunocompromised patients
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