[Endemic mycotic infections].
AIDS epidemics and intercontinental travels in endemic areas have increased the incidence of endemic mycoses (histoplasmosis, coccidioidomycosis, blastomycosis, penicilliosis). Environmental dimorphic fungi, through an aerial contamination cause them. Frequent in the HIV patients living in endemic areas, they represent an AIDS definition criterion. Most of primary infections are asymptomatic, they may also present as influenza or pneumonia, that will spontaneously recover. A secondary dissemination may especially occur among immunocompromised hosts involving most often the skin, central nervous system and bones. Lastly, a chronic pulmonary presentation may also occur. Direct examination and histology, cultures and serologies establish diagnosis. In all cases of disseminated or chronic infections, a long-term treatment is necessary, using amphotericin B and azoles. Life-time secondary prophylaxis is recommended in AIDS patients.
Briand
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V
Fédération de médecine interne maladies infectieuses et tropicales. Hôpital Avicenne Bobigny. olivier lortholary@avc.ap-hop-paris.fr
Lortholary
O
O
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001759:Blastomycosis / Q000175:diagnosis / Q000188:drug therapy; D003047:Coccidioidomycosis / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D015725:Fluconazole / Q000627:therapeutic use; D006660:Histoplasmosis / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D007654:Ketoconazole / Q000627:therapeutic use; D014195:Travel
D000935:Antifungal Agents; D017964:Itraconazole; D000666:Amphotericin B; D015725:Fluconazole; D007654:Ketoconazole