title: Histoplasmosis in immunocompetent individuals living in an endemic area in the Brazilian Southeast.
abstract: BACKGROUND
  The distribution of infection by Histoplasma capsulatum in Brazil is heterogeneous, and the number of cases affecting immunocompetent individuals is relatively small. This study reports the epidemiological and clinical data regarding histoplasmosis in non-immunosuppressed individuals.
  
  
  METHODS
  The study included only the immunocompetent patients with histoplasmosis who were diagnosed between 1970 and 2012 at a university hospital located in Ribeirão Preto, State of São Paulo, Brazil. Clinical and epidemiological data were collected retrospectively from the patient records.
  
  
  RESULTS
  Of the 123 patients analyzed, 95 had an active disease that manifested in the different clinical forms of histoplasmosis. Men were the predominant gender, and most patients resided in the Northeast of the State of São Paulo and in the nearby municipalities of the State of Minas Gerais. The risk factors for acquiring histoplasmosis and prolonged contact in a rural environment were recorded in 43.9% and 82.9% of cases, respectively. Smoking, alcoholism, and comorbidity rates were high among the patients with the chronic pulmonary and subacute/chronic disseminated forms of histoplasmosis. Many patients achieved clinical cure spontaneously, but 58.9% required antifungals; the disease lethality rate was 5.3%.
  
  
  CONCLUSIONS
  Immunocompetent individuals manifested the diverse clinical forms of histoplasmosis over a period of 4 decades, revealing an additional endemic area of this fungal disease in the Brazilian Southeast.
authors: Divisão de Moléstias Infecciosas e Tropicais, Departamento de Clínica Médica, Hospital das Clínicas, Faculdade de Medicina de Ribeiro Preto, Universidade de São Paulo, Ribeirão Preto, SP.
authors: Rivian Christina Lopes
authors: RC
authors: Faiolla
authors: Mariana Correa
authors: MC
authors: Coelho
authors: Rodrigo de Carvalho
authors: Rde C
authors: Santana
authors: Roberto
authors: R
authors: Martinez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases; D005260:Female; D006660:Histoplasmosis / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D007121:Immunocompetence / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult