ABSTRACT
OBJECTIVE: To analyze the epidemiological and clinical characteristics of Histoplasma capsulatum infection in a group of volunteers who had traveled to Guatemala. METHODS: A review was performed of the clinical records of nine patients who consulted at the Tropical Medicine Outpatient Unit of Hospital Clinic in Barcelona, Spain. RESULTS. All patients were attended for travelers' diarrhea. In addition, one student had also presented with respiratory symptoms and fever while in Guatemala and her chest X-ray showed interstitial infiltrates. The epidemiological history recognized risk factors for histoplasmosis in all patients (all of them had been working in the reconstruction of an old school building). The intradermal histoplasmin test was performed and was positive in all nine patients. None of the students required treatment. CONCLUSIONS: Histoplasmosis should be included in the differential diagnosis of returning travelers' fever. The diagnosis would have been missed in all of our patients if not for a directed clinical history taking. It is important to reinforce prevention measures, e.g. the use of face masks, when working in an environment with a risk for acquiring histoplasmosis.
Subject(s)
Histoplasmosis/diagnosis , Adult , Female , Guatemala , Histoplasmin , Histoplasmosis/epidemiology , Histoplasmosis/therapy , Humans , Male , TravelABSTRACT
Objetivo. Analizar las características epidemiológicas y clínicas de un grupo de cooperantes que presentó infección por H. capsulatum después de un viaje a Guatemala. Métodos. Revisión de historias clínicas de 9 pacientes atendidos en la Consulta de Medicina Tropical del Hospital Clínic. Resultados. El motivo de consulta fue diarrea del viajero en todos los casos, aunque una de las pacientes presentó sintomatología respiratoria y fiebre durante su estancia en Guatemala con infiltrados intersticiales en la radiología de tórax. La encuesta epidemiológica detectó factores de riesgo para la adquisición de Histoplasma (todos habían trabajado en la rehabilitación de una escuela vieja), motivo por el cual se realizó la prueba de histoplasmina, que resultó positiva en los 9 casos. Ningún paciente necesitó tratamiento. Conclusiones. La histoplasmosis debe incluirse en el diagnóstico diferencial de la fiebre del viajero. En nuestro grupo el diagnóstico hubiese pasado desapercibido en ausencia de una anamnesis dirigida. Es importante no olvidar y reforzar las medidas de prevención de la enfermedad en viajeros (p. ej., utilización de mascarillas de protección respiratoria si se trabaja en un entorno de riesgo) (AU)
Objective. To analyze the epidemiological and clinical characteristics of Histoplasma capsulatum infection in a group of volunteers who had traveled to Guatemala. Methods. A review was performed of the clinical records of nine patients who consulted at the Tropical Medicine Outpatient Unit of Hospital Clinic in Barcelona, Spain. Results. All patients were attended for travelers' diarrhea. In addition, one student had also presented with respiratory symptoms and fever while in Guatemala and her chest X-ray showed interstitial infiltrates. The epidemiological history recognized risk factors for histoplasmosis in all patients (all of them had been working in the reconstruction of an old school building). The intradermal histoplasmin test was performed and was positive in all nine patients. None of the students required treatment. Conclusions. Histoplasmosis should be included in the differential diagnosis of returning travelers' fever. The diagnosis would have been missed in all of our patients if not for a directed clinical history taking. It is important to reinforce prevention measures, e.g. the use of face masks, when working in an environment with a risk for acquiring histoplasmosis (AU)
