title: Differences in histoplasmosis in patients with acquired immunodeficiency syndrome in the United States and Brazil.
abstract: Demographic and clinical parameters among patients with acquired immunodeficiency syndrome and histoplasmosis in Brazil and United States were compared. The Brazilian isolates were typed by restriction-fragment length polymorphism analysis and were DNA fingerprinted by random amplification of polymorphic DNA (RAPD)-polymerase chain reaction (PCR). Skin lesions occurred in 66% of Brazilian case patients, compared with 1%-7% of US case patients. Of 21 treated case patients, 4 (19%) died, a rate similar to that of the US case patients (5%-13%). By nuclear gene typing, the Brazilian isolates were equally divided between South American classes 5 and 6, and RAPD-PCR showed 18 distinct genetic fingerprints in 20 isolates. Skin lesions are more common in infection with class 5 or 6 organisms than with class 2 Histoplasma capsulatum. The role of genetic differences in the organism as a cause for the clinical differences requires investigation.
authors.affiliation: Department of Medicine, Indiana University School of Medicine, Indianapolis, USA.
authors.forename: Kian
authors.initials: K
authors.lastname: Karimi
authors.forename: L Joseph
authors.initials: LJ
authors.lastname: Wheat
authors.forename: Patricia
authors.initials: P
authors.lastname: Connolly
authors.forename: Gretchen
authors.initials: G
authors.lastname: Cloud
authors.forename: Rana
authors.initials: R
authors.lastname: Hajjeh
authors.forename: Emerson
authors.initials: E
authors.lastname: Wheat
authors.forename: Katia
authors.initials: K
authors.lastname: Alves
authors.forename: Carlos da Silva
authors.initials: Cda S
authors.lastname: Lacaz Cd
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Keath
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology* / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001938:Brazil; D016172:DNA Fingerprinting / Q000379:methods; D005260:Female; D015658:HIV Infections / Q000150:complications; D006658:Histoplasma / Q000145:classification* / Q000235:genetics / Q000472:pathogenicity; D006660:Histoplasmosis / Q000382:microbiology / Q000503:physiopathology*; D006801:Humans; D007196:Indiana; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D019105:Random Amplified Polymorphic DNA Technique; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States
chemical_list: D000935:Antifungal Agents