1st International AIDS Conference Atlanta, Georgia, U.S.A. - April 14-17, 1985

Int Conf AIDS. 1985 Apr 14-17;1:26 Abstract No. S7D

Catherine B Small, D Hewlett, FP Duncanson, T Lenox, GP Wormser
New York Medical College, Valhalla; Misericordia Hospital and Medical Center, Bronx; Metropolitan Hospital, New York City; and Westchester County Medical Center, Valhalla, New York.

Six patients in high-risk groups for AIDS developed disseminated histoplasmosis while long-term residents of the New York City (NYC) area. All were born in Puerto Rico (PR). All were intravenous drug abusers and 1 was homosexual. Six had oral thrush, 2 had Pneumocystis carinii pneumonia, and 2 had Candida esophagitis. Prolonged fever, malaise, weight loss, hepatomegaly, and skin lesions were the predominant clinical findings. All developed bilateral interstitial infiltrates. Histoplasma serology was positive in 3 of 5 tested. Fungal cultures were positive in 5: bone marrow (4), liver (1), blood (1), lung (1). Fungal stains of tissue were also positive in 5. The only 2 patients diagnosed pre-mortem had a poor response to Amphotericin B and Ketoconazole.

Disseminated histoplasmosis is an important opportunistic infection in AIDS patients, even in those from nonendemic areas. Endogenous reinfection in patients who have previously resided in an endemic area (PR) is possible. Primary acquisition of Histoplasma capsulatum in NYC is a less likely explanation. The clinical picture is nonspecific. Cultures and fungal stains of bone marrow are the most useful diagnostic studies. Early diagnosis is necessary to initiate proper therapy.

850414
S7D

Copyright © 1985 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.