title: Update on the spectrum of histoplasmosis among hispanic patients presenting to a New York City municipal hospital: A contemporary case series.
abstract: Histoplasma capsulatum is the most common endemic mycosis worldwide. Although most of the globe's largest urban hubs fall outside this organism's regions of endemicity, clinicians practicing in a metropolis like New York City or Los Angeles must nevertheless remain vigilant for histoplasmosis because of the large immigrant population that is served by its hospitals. H. capsulatum infection ranges from asymptomatic pulmonary infection to life-threatening diffuse pneumonia with dissemination. The early years of the AIDS epidemic first introduced U.S. clinicians working in areas previously unfamiliar with histoplasmosis to newly immunocompromised patients from endemic regions presenting with disseminated H. capsulatum originally acquired in their home countries. Improvement in HIV prevention and therapeutics has reduced the frequency of such cases. Herein we report three cases of histoplasmosis encountered in our New York City institution over the last three years to emphasize that awareness of this infection remains mandatory for the frontline urban clinician.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Allegheny General Hospital, 320 E North Avenue, Pittsburgh, 15212 PA, USA.
authors.forename: Viral
authors.initials: V
authors.lastname: Gandhi
authors.affiliation: Department of Internal Medicine, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, USA.
authors.forename: Phillip
authors.initials: P
authors.lastname: Ulyanovskiy
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, USA.
authors.forename: Oleg
authors.initials: O
authors.lastname: Epelbaum
keywords: AIDS, Acquired immunodeficiency syndrome; ANCA, Anti-neutrophil cytoplasmic antibody; AZA, Azathioprine; BAL, Bronchoalveolar lavage; CT, Computed tomography; DH, Disseminated Histoplasmosis; ED, Emergency department; Fungal; HIV, Human immunodeficiency virus; Immunocompromised; L-AmB, Liposomal amphotericin B; Lung infection; NYC, New York City; RES, Reticuloendothelial system; TB, Tuberculosis