title: Acute histoplasmosis in three Mexican sewer workers.
abstract: We report the detection of high-titre anti-Histoplasma capsulatum IgM in the serum of three young adult males occupationally exposed to bat guano. Multidrug treatment with trimethoprim- sulfamethoxazole was started, followed by ciprofloxacin, clarithromycin, metamizole sodium, rifampicin/isoniazid/pyrazinamide, moxifloxacin and lastly amphotericin B and ceftriaxone. Despite treatment the condition of one patient deteriorated, and he died 23 days after exposure. The other two patients recovered after receiving similar therapy with the addition of voriconazole. They are currently being treated with itraconazole for a 1-year period.
authors.affiliation: División de Biología Molecular, Instituto Potosino de Investigación Científica y Tecnológica, A.C. (IPICYT), San Luis Potosi, Mexico. lsantos@ipicyt.edu.mx
authors.forename: L
authors.initials: L
authors.lastname: Santos
authors.forename: G
authors.initials: G
authors.lastname: Santos-Martínez
authors.forename: J E
authors.initials: JE
authors.lastname: Magaña-Ortíz
authors.forename: S L
authors.initials: SL
authors.lastname: Puente-Piñón
mesh_terms: D000208:Acute Disease; D000818:Animals; D002685:Chiroptera / Q000382:microbiology*; D017809:Fatal Outcome; D005243:Feces / Q000382:microbiology; D006658:Histoplasma; D006660:Histoplasmosis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D009784:Occupational Diseases / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations; D012722:Sewage / Q000382:microbiology*; D014937:Work; D055815:Young Adult
chemical_list: D007075:Immunoglobulin M; D012722:Sewage