title: [Outbreak of histoplasmosis in province of Neuquén, Patagonia Argentina].
abstract: BACKGROUND
  In Argentina, there are no reports of autochthonous cases of histoplasmosis in the southern regions of the country.
  
  
  OBJECTIVE
  To report a histoplasmosis outbreak in Zapala town, Province of Neuquén, Patagonia Argentina.
  
  
  METHODS
  We evaluated the clinical and epidemiological characteristics of 5 patients involved in the outbreak. Environmental studies were conducted to determine the source of infection. The genetic profile of Histoplasma capsulatum strains isolated from the index case (IC) were compared with clinical isolates from Argentinean patients not related to the outbreak, using RAPD-PCR with primers 1281-1283.
  
  
  RESULTS
  The patients were residents of Zapala, and had not visited other geographical areas before. All patients had an influenza-like syndrome, and X-ray revealed disseminated micronodular images throughout the lung parenchyma. The IC needed specific antifungal therapy; the remaining 4 patients had mild symptoms, and did not require therapy. All of them had a good clinical outcome. Strains of H. capsulatum isolated from blood culture and lung biopsy of the IC showed a genetic profile different from other strains analyzed. The presence of the fungus in the environment was demonstrated by the detection of anti-Histoplasma antibodies in BALB/c mice inoculated with soil obtained in a culvert where workers had dug up earth after a landslide.
  
  
  CONCLUSIONS
  This outbreak suggests the histoplasmosis endemic area is under the 38° S parallel. Patients from Neuquén, Patagonia Argentina, with compatible symptoms of histoplasmosis should be tested, regardless of their travel or exposure history.
authors: Hospital Provincial Neuquén Dr. Eduardo Castro Rendón, Neuquén Capital, Provincia de Neuquén, Argentina.
authors: Liliana María
authors: LM
authors: Calanni
authors: Rufina Ana
authors: RA
authors: Pérez
authors: Susana
authors: S
authors: Brasili
authors: Norma Graciela
authors: NG
authors: Schmidt
authors: Cristina Adela
authors: CA
authors: Iovannitti
authors: María Fernanda
authors: MF
authors: Zuiani
authors: Ricardo
authors: R
authors: Negroni
authors: Jorge
authors: J
authors: Finquelievich
authors: Cristina Elena
authors: CE
authors: Canteros
mesh_terms: D000328:Adult; D000818:Animals; D000908:Antibodies, Fungal / Q000097:blood; D000935:Antifungal Agents / Q000627:therapeutic use; D001118:Argentina / Q000453:epidemiology; D003131:Combined Modality Therapy; D060389:Construction Industry; D004271:DNA, Fungal / Q000032:analysis; D003937:Diagnosis, Differential; D004196:Disease Outbreaks; D019353:Endemic Diseases; D016469:Fungemia / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D006658:Histoplasma / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D006660:Histoplasmosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D008875:Middle Aged; D016273:Occupational Exposure; D010102:Oxygen Inhalation Therapy; D010802:Phylogeny; D019105:Random Amplified Polymorphic DNA Technique; D012988:Soil Microbiology
chemical_list: D000908:Antibodies, Fungal; D000935:Antifungal Agents; D004271:DNA, Fungal
keywords: Argentina; Brote; Histoplasma capsulatum; Histoplasmosis; Outbreak; RAPD-PCR