title: Fever in hospitalized HIV-infected patients in Western French Guiana: first think histoplasmosis.
abstract: In Western French Guiana, there was a dramatic increase in HIV prevalence between 1990 and 2000. The present study describes the causes of fever among HIV patients hospitalized in the medical ward of the only hospital in the western part of French Guiana. A retrospective descriptive study was conducted between 1 January 2008 and 30 June 2010 in the department of medicine of Saint Laurent du Maroni Hospital. The main characteristics of 67 patients having presented with fever in the first 48 hours of hospitalization were described. Among patients with CD4 <200/mm(3)the main febrile opportunistic infection was disseminated histoplasmosis (41.1%). Among patients with CD4 counts <50/mm(3)and fever without focal points 85.7% had disseminated histoplasmosis. Three patients died and all had disseminated histoplasmosis. Disseminated histoplasmosis is the most common febrile opportunistic infection in western French Guiana. Primary prophylaxis with itraconazole among immunocompromised patients seems warranted.
authors.affiliation: Centre hospitalier de l'ouest Guyanais, service de médecine, Saint Laurent du Maroni, French Guiana.
authors.forename: Vincent
authors.initials: V
authors.lastname: Vantilcke
authors.affiliation: Centre hospitalier de l'ouest Guyanais, Laboratoire Polyvalent, Saint Laurent du Maroni, French Guiana.
authors.forename: Rachida
authors.initials: R
authors.lastname: Boukhari
authors.affiliation: Centre hospitalier de l'ouest Guyanais, service de médecine, Saint Laurent du Maroni, French Guiana.
authors.forename: Anne
authors.initials: A
authors.lastname: Jolivet
authors.affiliation: Centre hospitalier de l'ouest Guyanais, service de médecine, Saint Laurent du Maroni, French Guiana.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Vautrin
authors.affiliation: Centre hospitalier de l'ouest Guyanais, service de médecine, Saint Laurent du Maroni, French Guiana.
authors.forename: Caroline
authors.initials: C
authors.lastname: Misslin
authors.affiliation: Centre d'investigation clinique épidémiologie clinique Antilles Guyane, INSERM CIC 1424, Centre hospitalier de Cayenne, French Guiana Epidemiologie des parasitoses et mycoses tropicales, EA 3593, Université des Antilles et de la Guyane, French Guiana.
authors.forename: Antoine
authors.initials: A
authors.lastname: Adenis
authors.affiliation: Centre d'investigation clinique épidémiologie clinique Antilles Guyane, INSERM CIC 1424, Centre hospitalier de Cayenne, French Guiana Epidemiologie des parasitoses et mycoses tropicales, EA 3593, Université des Antilles et de la Guyane, French Guiana mathieu.nacher@ch-cayenne.fr.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nacher
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D005260:Female; D005334:Fever / Q000209:etiology*; D005616:French Guiana / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016867:Immunocompromised Host; D017964:Itraconazole / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution; D015431:Weight Loss; D055815:Young Adult
chemical_list: C068538:liposomal amphotericin B; D017964:Itraconazole; D000666:Amphotericin B
keywords: AIDS; French Guiana; HIV; Histoplasma capsulatum; fever; histoplasmosis; opportunistic infection; primary prophylaxis