Histoplasmosis and penicilliosis: comparison of clinical features, laboratory findings and outcome.
BACKGROUND
Histoplasmosis and penicilliosis are infections caused by the dimorphic fungi, Histoplasma capsulatum and Penicillium marneffei, respectively. The aim of this study was to compare the clinical presentation, laboratory and radiologic findings and outcome of these infections at Srinagarind Hospital, Khon Kaen, Thailand.


METHODS
The medical records of patients who had positive cultures for Histoplasma capsulatum and Penicillium marneffei during 1996-2002 were reviewed. The data were compared and analyzed by the Chi-square and Fisher's exact tests.


RESULTS
There were 32 and 36 medical records of patients with H. capsulatum and P. marneffei infection, respectively, available for review. The most common underlying disease of patients with histoplasmosis and penicilliosis was acquired immunodeficiency syndrome (AIDS), which accounted for 90.6% and 91.7%, respectively. The most common clinical findings in both infections were fever, weight loss, cough, anemia, lymphadenopathy, hepatomegaly and splenomegaly. Frequencies of skin lesions were not statistically different between either group (P=0.20). Laboratory findings were similar between the two infections, except hyperbilirubinemia, which was more common in the penicilliosis group (P=0.02). There were similar abnormal X-ray findings in both groups with interstitial infiltration the most common abnormality.


CONCLUSIONS
Histoplasmosis and penicilliosis had similar clinical presentations, laboratory findings and chest X-ray abnormalities. Itraconazole is recommended as secondary prophylaxis in HIV-infected patients who have histoplasmosis or penicilliosis.
Mootsikapun
Piroon
P
Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand. piroon_m@hotmail.com
Srikulbutr
Sukanya
S
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy*; D000328:Adult; D000740:Anemia / Q000473:pathology; D000935:Antifungal Agents / Q000627:therapeutic use*; D003371:Cough / Q000473:pathology; D005260:Female; D005334:Fever / Q000473:pathology; D006529:Hepatomegaly / Q000473:pathology; D006658:Histoplasma; D006660:Histoplasmosis / Q000175:diagnosis / Q000188:drug therapy; D006785:Hospitals, University; D006801:Humans; D006932:Hyperbilirubinemia / Q000473:pathology; D017964:Itraconazole / Q000627:therapeutic use*; D008206:Lymphatic Diseases / Q000473:pathology; D008297:Male; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy*; D010407:Penicillium; D012189:Retrospective Studies; D013163:Splenomegaly / Q000473:pathology; D013785:Thailand; D016896:Treatment Outcome; D015431:Weight Loss
D000935:Antifungal Agents; D017964:Itraconazole