title: [Outbreak of acute histoplasmosis in Chilean travelers to the ecuadorian jungle: an example of geographic medicine].
abstract: Eight Chilean teenagers traveled to Ecuador in January 1999, where they were bitten by mosquitoes, had contact with parakeets and lodged in poorly hygienic places; 6/8 visited for 5-10 minutes the interior of a bat cave. About a week later these 6 began with headache, myalgia and fever that lasted 2-3 weeks. 5/6 had dry cough with no respiratory distress. The index case was seen in the 2nd week of symptoms. A chest x-ray showed multiple nodular infiltrates as in the other five. Two had histoplasma serology, one was negative and the other positive at a low titer; histoplasmin skin test showed induration of 17-27 mm in all six. An acute histoplasmosis with massive exposure was diagnosed and treated with itraconazole for 3 weeks. All became asymptomatic and chest x-rays returned to normal. Histoplasmosis (non existent endogenously in Chile) is, among other geographic and tropical diseases, a risk for Chilean travelers. Awareness of this in the general population and development of expertise in these diseases by local health care providers is required.
authors.affiliation: Departamento de Medicina Centro, Facultad de Medicina, Universidad de Chile, Hospital San Borja Arriarán.
authors.forename: M
authors.initials: M
authors.lastname: Wolff
mesh_terms: D000293:Adolescent; D000935:Antifungal Agents / Q000627:therapeutic use; D002677:Chile / Q000453:epidemiology; D004196:Disease Outbreaks; D004484:Ecuador; D006660:Histoplasmosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male
chemical_list: D000935:Antifungal Agents; D017964:Itraconazole