title: Tuberculosis and histoplasmosis co-infection in AIDS patients.
abstract: Abstract. Coinfection with tuberculosis in some countries occurs in 8-15% of human immunodeficiency virus (HIV) -infected patients who have histoplasmosis. This coinfection interferes with prompt diagnosis, and treatment is difficult because of drug interactions. We retrospectively reviewed the cases of 14 HIV-infected patients who had concomitant tuberculosis and histoplasmosis. The most frequent clinical manifestations were weight loss (85.7%), asthenia (78.5%), and fever (64.2%). The diagnosis of histoplasmosis was made primarily by histopathology (71.4%), and the diagnosis of tuberculosis was made by means of direct microscopic examination (71.4%). Death occurred in two patients, and relapse of both infections occurred in one patient. Moxifloxacin was substituted for rifampicin in six patients, with good outcomes noted for both infections. The clinical presentation does not readily identify acquired immunodeficiency syndrome (AIDS) patients who have tuberculosis and histoplasmosis. The use of a fluoroquinolone as an alternative agent in place of rifampicin for tuberculosis allows effective therapy with itraconazole for histoplasmosis.
authors.affiliation: Corporación para Investigaciones Biológicas (CIB), Medellín, Colombia. carlosagudelo@yahoo.com
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Agudelo
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Restrepo
authors.forename: Diego A
authors.initials: DA
authors.lastname: Molina
authors.forename: Angela M
authors.initials: AM
authors.lastname: Tobón
authors.forename: Carol A
authors.initials: CA
authors.lastname: Kauffman
authors.forename: Carolina
authors.initials: C
authors.lastname: Murillo
authors.forename: Angela
authors.initials: A
authors.lastname: Restrepo
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D060085:Coinfection / Q000175:diagnosis* / Q000382:microbiology / Q000469:parasitology; D003840:Deoxycholic Acid / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006660:Histoplasmosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014376:Tuberculosis / Q000150:complications* / Q000175:diagnosis / Q000473:pathology
chemical_list: D000935:Antifungal Agents; D004338:Drug Combinations; D003840:Deoxycholic Acid; D017964:Itraconazole; D000666:Amphotericin B; C059765:amphotericin B, deoxycholate drug combination