Brote de histoplasmosis aguda en viajeros chilenos a la selva ecuatoriana: un ejemplo de medicina geográfica / Outbreak of acute histoplasmosis in chilean travelers to the Ecuadorïs jungle: report of 6 cases as an example of geographic medicine

RESUMO

Eight chilean teenagers traveled to Ecuador in january 1999, where they were bitten by mosquitoes, had contact with parakeets and lodged in poorly hygienic places; 6/8 visited for 5-10 minutes the interior of a bat cave. About a week later these 6 began with headache, myalgia and fever that lasted 2-3 weeks. 5/6 had dry cough with no respiratory distress. The index case was seen in the 2nd week of symptoms. A chest x-ray showed multiple nodular infiltrates as in the other five. Two had histoplasma serology, one was negative and the other positive at a low titer; histoplasmine skin test showed induration of 17-27 mm in all six. An acute histoplasmosis with massive exposure was diagnosed and treated with itraconazole for 3 weeks. All became asymptomatic and chest x-rays returned to normal. Histoplasmosis (non existent endogenously in Chile) is, among other geographic and tropical diseases, a risk for chilean travelers. Awareness of this in the general population and development of expertise in these diseases by local health care providers is required