AEGiS-11IAC: Disseminated histoplasmosis in HIV patients with mucocutaneous lesions. A prospective study in Sao Paulo, Brazil.

11th International AIDS Conference


Vancouver, British Columbia — July 7-12, 1996

Print this Article


Disseminated histoplasmosis in HIV patients with mucocutaneous lesions. A prospective study in Sao Paulo, Brazil.

Int Conf AIDS 1996 Jul 7-12; 11:446 (abstract no. Pub.B.1053)
Alves KS, Del Negro GB, Melhem MS, Silva ML, Wagon BB, Oyafuso LK, Lacaz CS; Instituto de Infectologia Emilio Ribas, Sao Paulo, Brazil. Fax: 55 11 3061-3900. E-mail: kaos@usp.br.

OBJECTIVE: Describe HIV patients with disseminated histoplamosis and mucocutaneous lesions identified between January/1994 and January/1996 in Instituto de Infectologia Emilio Ribas, Sao paulo, Brazil. Method: All HIV patients with fever, reticuloendothelial involvement, and/or skin lesions were cultured for fungus blood using biphasic brain heart infusion (BHI) medium - at 30degrees C for 40 days, and skin and lymph node biopsies using BHI and Sabouraud dextrose agar medium,and were tested serologically by double imunnodiffusion (DID), counterimunnoelectrophoresis (CIE) and complement fixation (CF).

RESULTS: We identified Histoplasma capsulatum. on 20 (43.5%) cases (2 women, 10% and 18 men, 90%) among 46 HIV patients. Histoplasmosis was the first opportunistic infection on 14/20 (70%) patients. CD4 counts performed by flow cytometer on 12 (85.7%) patients was less than 50 cells/mm3 and in 2 (14.3%) patients greater than 100 cells/mm3 (122 and 134 respectively). DID was positive for 7 (36.8%) patients, CIE varied within 1/2 to 1/64 in 6 (31.6%) patients and CF from 1/8 to 1/128 in 3 (15.8%) patients. Polymorphic mucocutaneous lesions were present in 18 cases consisting of erythematous papules, plaques and nodules, pustules, erosions, ulcers and crusts. Two cases presented rhinophyma of nose.

CONCLUSION: Culture for fungus should be performed for all skin biopsies. Serology for detection of specific antibody have low sensitivity and little value for diagnosis. There is no standardization for disseminated histoplasmosis skin lesions on HIV patients.

Keywords: AEGIS, Histoplasmosis, HIV, Histoplasma, CD4 Lymphocyte Count, HIV Infections, HIV-2, Prospective Studies, HIV-1, Opportunistic Infections, Skin Diseases, HIV Seropositivity, Biopsy, Skin, Brazil, Human, Female, Male, ICA11KWDaegis,histoplasmosis,hiv,histoplasma,cd4lymphocytecount,hivinfections,hiv-2,prospectivestudies,hiv-1,opportunisticinfections,skindiseases,hivseropositivity,biopsy,skin,brazil,human,female,male,ica11

960707
PubB1053

Copyright © 1996 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.