DISSEMINATED HISTOPLASMOSIS AND AIDS - 4 CASES

Disseminated histoplasmosis is frequent in patients with HIV infection from endemic zones of Africa and South America. It is unfrequent in E urope. Four cases diagnosed as disseminated histoplasmosis among a tot al of 1,100 AIDS cases reported from 1984 to 1994 were reviewed. Four males with a mean age of 40 years were reviewed. Two were from Argenti na, one from Gambia with HIV-2 infection and the remaining case was a Spanish man who had made numerous travels to endemic zones. Prolonged fever without an apparent focci in the previous weeks was the clinical manifestation at the onset in all the cases. Diagnosis was performed by bone marrow aspirate (1 case), histologic study of the cutaneous le sions (1 case) and on autopsy with the diagnosis not being suspected d uring life (2 cases), Tracheal ulcers and hyperferritinemia are the ma in peculiarities of the two cases presented. Antifungal treatment with amphotericin B and secondary prophylaxis with itraconazole were effec tive in one of the cases. It is important to take histoplasmosis into account in the differential diagnosis of prolonged fever in patients w ith HIV infection from endemic zones.