title: HIV-associated disseminated histoplasmosis in western French Guiana, 2002-2012.
abstract: Disseminated histoplasmosis (DH) is the most current revelation mode of AIDS in French Guiana. We describe the clinical and paraclinical presentation of DH, diagnostic tools, evolution and factors associated with 1-year mortality in HIV-infected patients from western French Guiana. Microbiologically proven AIDS-related DH in Saint Laurent du Maroni's hospital between May 2002 and May 2012 were retrospectively included. Among the 82 patients included, 58 (71%) were male, 44 (53%) presented concurrent histoplasmosis and HIV diagnosis and 63 (80%) had a CD4 cell count under 50 cells μL(-1). Almost all patients had weight loss (97%) and fever (95%), while 84% had digestive symptoms (63% diarrhoea), 55% lymphadenopathy, and 49% respiratory symptoms. Documented and presumed locations of H. capsulatum var capsulatum (Hcc) concerned almost all organs, with a particular affinity for the bone marrow and the digestive system. Co-infections were associated in 65%. Following treatment initiation, 10 patients (13%) died within 1 month and 17 patients (25%) died within a year. DH is a polymorphous systemic mycosis with haematological and digestive tropism. Co-infections are frequent and mortality rate is high.
authors: Department of Medicine, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, French Guiana.
authors: A
authors: A
authors: Putot
authors: S
authors: S
authors: Perrin
authors: A
authors: A
authors: Jolivet
authors: V
authors: V
authors: Vantilcke
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis / Q000401:mortality; D000328:Adult; D001853:Bone Marrow / Q000382:microbiology; D018791:CD4 Lymphocyte Count; D060085:Coinfection; D003967:Diarrhea; D005260:Female; D005334:Fever; D005616:French Guiana; D041981:Gastrointestinal Tract / Q000382:microbiology; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D008206:Lymphatic Diseases / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D015431:Weight Loss
keywords: French Guiana; HIV; Histoplasmosis; diagnosis; opportunistic disease; prognosis