CASE-REPORT AND REVIEW OF DISSEMINATED HISTOPLASMOSIS IN SOUTH-EAST ASIA - CLINICAL AND EPIDEMIOLOGIC IMPLICATIONS

The South-East Asian region is not known to be a major endemic area fo r histoplasmosis. We have recently diagnosed several cases of dissemin ated histoplasmosis in patients from this region. We report on a well documented indigenous case of disseminated histoplasmosis in a 62-year -old poultry farmer and review the literature for other reported cases of clinical histoplasmosis in the South-East Asian region. Sporadic c ases of indigenous chronic pulmonary and non-meningeal disseminated hi stoplasmosis in immunocompetent hosts have been reported as well as ex amples of disseminated histoplasmosis in immunocompromised hosts. Thes e reports suggest that histoplasmosis is endemic to certain areas in S outh-East Asia and that there may be a large number of undiagnosed and subclinical cases. The recent advances in diagnostic tests for histop lasmosis are also reviewed with reference to the experience of using t hese tests in the reported case.