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Histoplasma and Histoplasmosis 2023
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Histoplasma and Histoplasmosis 2023

A special issue of Journal of Fungi (ISSN 2309-608X). This special issue belongs to the section "Fungal Pathogenesis and Disease Control".

Deadline for manuscript submissions: closed (30 November 2023) | Viewed by 16473

Special Issue Editors

Prof. Dr. Mathieu Nacher

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Guest Editor
Medicine Department, Ecosystemes Amazoniens et Pathologie Tropicale, EA 3593, Labex CEBA, University of French Guiana, Cayenne, France
Interests: HIV infectious diseases; malaria; AIDS; Plasmodium; Falciparum malaria; Vivax malaria
Special Issues, Collections and Topics in MDPI journals
Dr. Antoine A. Adenis

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Guest Editor
Centre d’Investigation Clinique Antilles Guyane, CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, France
Interests: fungal infections; tropical medicine; epidemiology; public health; HIV
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Progressive disseminated histoplasmosis is still too often underdiagnosed; this has resulted in a great burden of avoidable deaths in Latin America and presumably in other continents. There are diagnostic difficulties for this proteiform disease that lead to a significant risk of death; these diagnostic problems also lead to a lack of data and awareness among physicians. Despite recent WHO/PAHO histoplasmosis diagnosis and treatment guidelines, challenges still lay ahead, especially in low- and middle-income countries. There are still many unanswered questions regarding the natural history of disseminated histoplasmosis and who should be tested, when, and what to do if the test is positive in patients without symptoms. The disease burden beyond the Americas, reports documenting the scaling-up of diagnoses and treatments, prognostic factors, new tools and strategies, and the disease’s rising incidence in non-HIV immunosuppression are examples of topics that this Special Issue of the Journal of Fungi will seek to explore.

Prof. Dr. Mathieu Nacher
Dr. Antoine A. Adenis
Guest Editors

Manuscript Submission Information

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Keywords

  • histoplasma
  • histoplasmosis
  • endemic fungi
  • opportunistic infections
  • AIDS
  • fungal epidemiology

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Related Special Issues

Published Papers (7 papers)

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Research

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8 pages, 265 KiB  
Communication
Prevalence of Histoplasma Antigenuria among Outpatient Cohort with Advanced HIV in Kampala, Uganda
by Preethiya Sekar, Elizabeth Nalintya, Richard Kwizera, Claudine Mukashyaka, Godfrey Niyonzima, Loryndah Olive Namakula, Patricia Nerima, Ann Fieberg, Biyue Dai, Jayne Ellis, David R. Boulware, David B. Meya, Nathan C. Bahr and Radha Rajasingham
J. Fungi 2023, 9(7), 757; https://doi.org/10.3390/jof9070757 - 18 Jul 2023
Cited by 3 | Viewed by 1794
Abstract
In sub-Saharan Africa, an estimated 25% of people with HIV present with advanced HIV and are at high risk of opportunistic infections. Whereas histoplasmosis has occasionally been seen in Uganda, the understanding of the local risk of acute infection is limited. We sought [...] Read more.
In sub-Saharan Africa, an estimated 25% of people with HIV present with advanced HIV and are at high risk of opportunistic infections. Whereas histoplasmosis has occasionally been seen in Uganda, the understanding of the local risk of acute infection is limited. We sought to determine the prevalence of Histoplasma antigenuria using an enzyme immunoassay (EIA, clarus Histoplasma GM EIA, IMMY; Norman, OK, USA) in a cohort of outpatients with advanced HIV disease in Kampala, Uganda. Among the persons with positive urine Histoplasma antigen tests, we assessed their clinical presentation and outcomes. The EIA was run on stored urine samples as per the manufacturer’s instructions. Specimens ≥1 EIA units were considered positive. Among the 388 tested urine samples, 4 (1.2%) were positive for Histoplasma antigen. The histoplasmosis prevalence among participants with a CD4 < 100 cells/mcL was 2.5% (4/158). Three of the four participants with a positive Histoplasma antigen test reported systemic symptoms consistent with histoplasmosis. All four participants had a positive urine lipoarabinomannan test and were treated for tuberculosis. By the four-week follow-up visit, all participants were clinically improved, alive, and in care without antifungal therapy. In advanced HIV, the clinical presentations of tuberculosis and histoplasmosis overlap. The value of histoplasmosis screening and pre-emptive treatment is an area of future research. Full article
(This article belongs to the Special Issue Histoplasma and Histoplasmosis 2023)
7 pages, 262 KiB  
Communication
Application of Real-Time PCR Assays for the Diagnosis of Histoplasmosis in Human FFPE Tissues Using Three Molecular Targets
by Luisa F. López, Ángela M. Tobón, Diego H. Cáceres, Tom Chiller, Anastasia P. Litvintseva, Lalitha Gade, Ángel González and Beatriz L. Gómez
J. Fungi 2023, 9(7), 700; https://doi.org/10.3390/jof9070700 - 25 Jun 2023
Cited by 2 | Viewed by 1729
Abstract
Histoplasmosis is a fungal infection caused by the thermally dimorphic fungus Histoplasma capsulatum. This infection causes significant morbidity and mortality in people living with HIV/AIDS, especially in countries with limited resources. Currently used diagnostic tests rely on culture and serology but with some [...] Read more.
Histoplasmosis is a fungal infection caused by the thermally dimorphic fungus Histoplasma capsulatum. This infection causes significant morbidity and mortality in people living with HIV/AIDS, especially in countries with limited resources. Currently used diagnostic tests rely on culture and serology but with some limitations. No molecular assays are commercially available and the results from different reports have been variable. We aimed to evaluate quantitative real-time PCR (qPCR) targeting three protein-coding genes of Histoplasma capsulatum (100-kDa, H and M antigens) for detection of this fungus in formalin-fixed paraffin-embedded (FFPE) samples from patients with proven histoplasmosis. The sensitivity of 100-kDa, H and M qPCR assays were 93.9%, 91% and 57%, respectively. The specificity of 100-kDa qPCR was 93% when compared against samples from patients with other mycoses and other infections, and 100% when samples from patients with non-infectious diseases were used as controls. Our findings demonstrate that real-time PCR assays targeting 100-kDa and H antigen showed the most reliable results and can be successfully used for diagnosing this mycosis when testing FFPE samples. Full article
(This article belongs to the Special Issue Histoplasma and Histoplasmosis 2023)

Review

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20 pages, 1527 KiB  
Review
Histoplasmosis in Solid Organ Transplantation
by Nicolas Barros and L. Joseph Wheat
J. Fungi 2024, 10(2), 124; https://doi.org/10.3390/jof10020124 - 2 Feb 2024
Cited by 1 | Viewed by 2838
Abstract
Histoplasma capsulatum, the etiological agent for histoplasmosis, is a dimorphic fungus that grows as a mold in the environment and as a yeast in human tissues. It has a broad global distribution with shifting epidemiology during recent decades. While in immunocompetent individuals [...] Read more.
Histoplasma capsulatum, the etiological agent for histoplasmosis, is a dimorphic fungus that grows as a mold in the environment and as a yeast in human tissues. It has a broad global distribution with shifting epidemiology during recent decades. While in immunocompetent individuals infection is usually self-resolving, solid organ transplant recipients are at increased risk of symptomatic disease with dissemination to extrapulmonary tissue. Diagnosis of histoplasmosis relies on direct observation of the pathogen (histopathology, cytopathology, and culture) or detection of antigens, antibodies, or nucleic acids. All transplant recipients with histoplasmosis warrant therapy, though the agent of choice and duration of therapy depends on the severity of disease. In the present article, we describe the pathogenesis, epidemiology, clinical manifestations and management of histoplasmosis in solid organ transplant recipients. Full article
(This article belongs to the Special Issue Histoplasma and Histoplasmosis 2023)
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12 pages, 823 KiB  
Review
Closing the Gap in Proteomic Identification of Histoplasma capsulatum: A Case Report and Review of Literature
by Terenzio Cosio, Roberta Gaziano, Carla Fontana, Enrico Salvatore Pistoia, Rosalba Petruccelli, Marco Favaro, Francesca Pica, Silvia Minelli, Maria Cristina Bossa, Anna Altieri, Domenico Ombres, Nikkia Zarabian and Cartesio D’Agostini
J. Fungi 2023, 9(10), 1019; https://doi.org/10.3390/jof9101019 - 15 Oct 2023
Cited by 1 | Viewed by 3138
Abstract
Histoplasmosis is a globally distributed systemic infection caused by the dimorphic fungus Histoplasma capsulatum (H. capsulatum). This fungus can cause a wide spectrum of clinical manifestations, and the diagnosis of progressive disseminated histoplasmosis is often a challenge for clinicians. Although microscopy [...] Read more.
Histoplasmosis is a globally distributed systemic infection caused by the dimorphic fungus Histoplasma capsulatum (H. capsulatum). This fungus can cause a wide spectrum of clinical manifestations, and the diagnosis of progressive disseminated histoplasmosis is often a challenge for clinicians. Although microscopy and culture remain the gold standard diagnostic tests for Histoplasma identification, matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS) has emerged as a method of microbial identification suitable for the confirmation of dimorphic fungi. However, to our knowledge, there are no entries for H. capsulatum spectra in most commercial databases. In this review, we describe the case of disseminated histoplasmosis in a patient living with HIV admitted to our university hospital that we failed to identify by the MALDI-TOF method due to the limited reference spectrum of the instrument database. Furthermore, we highlight the utility of molecular approaches, such as conventional polymerase chain reaction (PCR) and DNA sequencing, as alternative confirmatory tests to MALDI-TOF technology for identifying H. capsulatum from positive cultures. An overview of current evidence and limitations of MALDI-TOF-based characterization of H. capsulatum is also presented. Full article
(This article belongs to the Special Issue Histoplasma and Histoplasmosis 2023)
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11 pages, 591 KiB  
Review
The Current and Future States of Diagnostic Tests for Histoplasmosis with a Focus on People with HIV and Disseminated Histoplasmosis
by Kenneth Villareal, Austin Price, Alessandro C. Pasqualotto and Nathan C. Bahr
J. Fungi 2023, 9(8), 793; https://doi.org/10.3390/jof9080793 - 28 Jul 2023
Cited by 9 | Viewed by 2993
Abstract
Histoplasmosis is caused by Histoplasma capsulatum and, although endemic in large parts of the world, is often underrecognized in many locations. In addition to underrecognition, inadequate availability of diagnostic tests is a major contributor to poor outcomes in disseminated disease in people with [...] Read more.
Histoplasmosis is caused by Histoplasma capsulatum and, although endemic in large parts of the world, is often underrecognized in many locations. In addition to underrecognition, inadequate availability of diagnostic tests is a major contributor to poor outcomes in disseminated disease in people with HIV. For those with advanced HIV and disseminated disease, antibody testing is less useful. Culture and histopathology can be useful in this situation, but each has limitations, including variable sensitivity by site and, in the case of culture, the need for a biosafety level three laboratory and a long period of growth. Antigen testing has proven useful for disseminated histoplasmosis due to the excellent sensitivity of urine. Yet, turnaround is slower than ideal due to use in a limited number of centers. The development of lateral flow assays has the potential to make for true rapid point-of-care assays for histoplasmosis, but in order to meet that promise, the tests must be widely available and affordable. Full article
(This article belongs to the Special Issue Histoplasma and Histoplasmosis 2023)
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15 pages, 362 KiB  
Review
Tackling Histoplasmosis Infection in People Living with HIV from Latin America: From Diagnostic Strategy to Public Health Solutions
by Diego H. Cáceres, Beatriz L. Gómez, Ángela M. Tobón, Ángela Restrepo, Tom Chiller, Mark D. Lindsley, Jacques F. Meis and Paul E. Verweij
J. Fungi 2023, 9(5), 558; https://doi.org/10.3390/jof9050558 - 11 May 2023
Cited by 6 | Viewed by 2373
Abstract
Histoplasmosis, caused by the thermally dimorphic fungus Histoplasma spp., is a disease with a broad clinical spectrum, presenting from asymptomatic/flu-like symptoms to progressive disseminated disease in people with immunosuppression. In recent years, the concept of histoplasmosis as a disease restricted to the American [...] Read more.
Histoplasmosis, caused by the thermally dimorphic fungus Histoplasma spp., is a disease with a broad clinical spectrum, presenting from asymptomatic/flu-like symptoms to progressive disseminated disease in people with immunosuppression. In recent years, the concept of histoplasmosis as a disease restricted to the American continent has changed, as now histoplasmosis is reported in many regions around the world. In Latin America, histoplasmosis represents a threat, especially in people with advanced HIV disease (AHD). Diagnosis of histoplasmosis in people living with HIV (PLHIV) is challenging due to the low index of suspicion of the disease, non-specificity of signs and symptoms, and limited access to specific laboratory testing, while the diagnostic delay is significantly associated with mortality. In the last decade, novel diagnostic tests have been developed for the rapid detection of histoplasmosis, such as commercial kits for antigen detection. Furthermore, advocacy groups were created that presented histoplasmosis as a public health problem, with emphasis on patients at risk of progressive disseminated disease. This review aims to discuss the impact of histoplasmosis associated with AHD in Latin America and the strategies employed to tackle histoplasmosis, from the implementation of laboratory testing to disease advocacy and public health interventions. Full article
(This article belongs to the Special Issue Histoplasma and Histoplasmosis 2023)

Other

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10 pages, 116796 KiB  
Case Report
Disseminated Histoplasmosis in an Immunocompetent Patient from Southern Arizona
by Monique Crawford, Troy Weinstein, Alexis Elliott, Robert Klein, Michael Lee, Conner Reynolds and Talha Riaz
J. Fungi 2024, 10(11), 756; https://doi.org/10.3390/jof10110756 - 31 Oct 2024
Viewed by 402
Abstract
In this review, we present a case report of an immunocompetent 58-year-old male who presented with disseminated histoplasmosis (DH) outside of the known endemic regions. Due to his atypical clinical presentation that did not fit the classical clinical picture of DH, the diagnosis [...] Read more.
In this review, we present a case report of an immunocompetent 58-year-old male who presented with disseminated histoplasmosis (DH) outside of the known endemic regions. Due to his atypical clinical presentation that did not fit the classical clinical picture of DH, the diagnosis was delayed. In addition, we researched DH in the immunocompetent hosts as these cases are not common and leave the patient population vulnerable to delayed diagnosis. The literature supports considering histoplasmosis in the differential diagnosis among patients who present with possible exposures outside of endemic regions and are immunocompetent. Full article
(This article belongs to the Special Issue Histoplasma and Histoplasmosis 2023)
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