title: An outbreak of histoplasmosis among healthy young Japanese women after traveling to Southeast Asia.
abstract: Histoplasmosis, caused by Histoplasma capsulatum, is an endemic mycosis in many countries of the world except for Japan. Outbreaks of histoplasmosis among Japanese people are very rare and are mainly imported by travelers. We report an outbreak of histoplasmosis among healthy Japanese people who traveled to a resort area in Southeast Asia. Three young Japanese women traveled to Langkawi island, Malaysia and stayed on the island for five days without visiting caves, a known reservoir of H. capsulatum. All three individuals developed flu-like symptoms with multiple nodule shadows on chest X rays or chest CT scans at around ten days after their return to Japan. Serum samples obtained from the three subjects were positive for anti-Histoplasma antibody and specific PCR for H. capsulatum on lung biopsy specimens and the serum from one patient was positive. The clinical course of all three patients improved without the use of anti-fungal agents and no recurrence has been confirmed. Clinical attendants should consider histoplasmosis when they see patients with flu-like symptoms with abnormal chest X-rays after visiting H. capsulatum endemic areas, especially Southeast Asia.
authors.affiliation: Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Ohno
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Ogata
authors.forename: Hajime
authors.initials: H
authors.lastname: Suguro
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yokota
authors.forename: Akira
authors.initials: A
authors.lastname: Watanabe
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kamei
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamagoe
authors.forename: Akiko
authors.initials: A
authors.lastname: Ishida-Okawara
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Atsuko
authors.initials: A
authors.lastname: Horino
authors.forename: Kunikazu
authors.initials: K
authors.lastname: Yamane
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsuji
authors.forename: Noriyo
authors.initials: N
authors.lastname: Nagata
authors.forename: Hideki
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Yoshichika
authors.initials: Y
authors.lastname: Arakawa
authors.forename: Tetsutaro
authors.initials: T
authors.lastname: Sata
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Miyazaki
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D001210:Asia, Southeastern / Q000453:epidemiology; D001706:Biopsy; D019353:Endemic Diseases; D005260:Female; D006658:Histoplasma / Q000302:isolation & purification; D006660:Histoplasmosis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008168:Lung / Q000382:microbiology / Q000473:pathology; D014195:Travel
chemical_list: D000935:Antifungal Agents