An outbreak of histoplasmosis among healthy young Japanese women after traveling to Southeast Asia.
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.
Ohno
Hideaki
H
Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo.
Ogata
Yoshiko
Y
Suguro
Hajime
H
Yokota
Soichiro
S
Watanabe
Akira
A
Kamei
Katsuhiko
K
Yamagoe
Satoshi
S
Ishida-Okawara
Akiko
A
Kaneko
Yukihiro
Y
Horino
Atsuko
A
Yamane
Kunikazu
K
Tsuji
Takahiro
T
Nagata
Noriyo
N
Hasegawa
Hideki
H
Arakawa
Yoshichika
Y
Sata
Tetsutaro
T
Miyazaki
Yoshitsugu
Y
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
D000935:Antifungal Agents