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BIBTEX RIS

Histoplasmosis in HIV-positive patients in Ceará, Brazil: clinical-laboratory aspects and in vitro antifungal susceptibility of Histoplasma capsulatum isolates

2012; Oxford University Press; Volume: 106; Issue: 8 Linguagem: Inglês

10.1016/j.trstmh.2012.05.003

ISSN

1878-3503

Autores

Raimunda Sâmia Nogueira Brilhante, Maria Auxiliadora Bezerra Fechine, Jacó Ricarte Lima de Mesquita, Rossana de Aguiar Cordeiro, Marcos Fábio Gadelha Rocha, André Jalles Monteiro, Rita Amanda Chaves de Lima, Érica Pacheco Caetano, Juliana Fernandes Pereira, Débora de Souza Collares Maia Castelo‐Branco, Zoilo Pires dè Camargo, José Júlio Costa Sidrim,

Tópico(s)

Nail Diseases and Treatments

Resumo

This study contains a descriptive analysis of histoplasmosis in AIDS patients between 2006 and 2010 in the state of Ceará, Brazil. Additionally, the in vitro susceptibility of Histoplasma capsulatum isolates obtained during this period was assessed. We report 208 cases of patients with histoplasmosis and AIDS, describing the epidemiological, clinical, laboratory and therapeutic aspects. The in vitro antifungal susceptibility test was carried out by the microdilution method, according to Clinical and Laboratory Standards Institute, with H. capsulatum in the filamentous and yeast phases, against the antifungals amphotericin B, fluconazole, itraconazole, voriconazole and caspofungin. In 38.9% of the cases, histoplasmosis was the first indicator of AIDS and in 85.8% of the patients the CD4 cell count was lower than 100 cells/mm(3). The lactate dehydrogenase levels were high in all the patients evaluated, with impairment of hepatic and renal function and evolution to death in 42.3% of the cases. The in vitro susceptibility profile demonstrated there was no antifungal resistance among the isolates evaluated. There was a significant increase in the number of histoplasmosis cases in HIV-positive patients during the period surveyed in the state of Ceará, northeastern Brazil, but no antifungal resistance among the recovered isolates of H. capsulatum.

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