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Report of Five Cases From a Nonendemic Area

Chin Tang Huang, MD; Terence McGarry, MD; Scott Cooper, MD; Richard Saunders, MD; Rao Andavolu, MD

Arch Intern Med. 1987;147(6):1181-1184.

Abstract
• Disseminated histoplasmosis is predominantly a disease of the immunocompromised. However, it has been reported infrequently in patients with the acquired immunodeficiency syndrome (AIDS), and then almost exclusively from patients residing in endemic areas. We report five cases of disseminated histoplasmosis in patients with AIDS in a nonendemic area. The initial diagnosis was made by fiberoptic bronchoscopy in three patients and by bone marrow and liver biopsy specimens in one patient each. All patients had fungemia, septic shock, and multiple organ involvement. Three patients had a fulminant course and died within four weeks. Two patients had more prolonged courses, with one survival period of ten months. We conclude that patients with AIDS are at high risk to contract disseminated histoplasmosis with an extremely high morbidity and mortality. This risk is not limited to residents of endemic areas.

(Arch Intern Med 1987;147:1181-1184)

Author Affiliations
From the Departments of Medicine (Drs Huang, McGarry, Cooper, and Saunders) and Pathology (Dr Andavolu), Lincoln Medical and Mental Health Center, New York Medical College, the Bronx.

Footnotes
Accepted for publication March 31, 1987.

Reprint requests to Department of Medicine, Lincoln Medical and Mental Health Center, Bronx, NY 10451 (Dr Huang).

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