1921
Volume 74, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

We performed a retrospective study of 164 human immunodeficiency virus (HIV)–infected patients with disseminated histoplasmosis to identify the risk factors for death. Death occurred in 32% of the cases. Univariate analysis identified the following risk factors: diarrhea (odds ratio [OR] = 3.9, = 0.001), neurologic manifestations (OR = 5.8, ; = 0.001), hemoglobin level < 8.0g/dL (OR = 2.7, = 0.004), urea level 2 times the normal upper limit (OR = 5.0, < 0.001), creatinine level > 1.5 mg/dL (OR = 2.9, = 0.005), aspartate aminotransferase (AST) level > 2.5 times the normal upper limit (OR = 3.1, = 0.01), respiratory insufficiency (OR = 9.7, < 0.001), sepsis (OR = 20.2, < 0.001), and acute renal failure (OR = 2.5, = 0.011). A hemoglobin level < 8.0 g/dL (OR = 3.8, = 0.008), an AST level ≥ 2.5 times the normal limit (OR = 1.0, = 0.007), acute renal failure (OR = 2.96, = 0.015), and respiratory insufficiency (OR = 12.2, = 0.01) were independent risk factors for death.

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References

  1. Centers for Disease Control, 1987. Revision of the CDC surveillance case definition for the acquired immunodeficiency syndrome. MMWR Morb Mortal Wkly Rep 36 : 1S–15S. [Google Scholar]
  2. Wheat LJ, Chetchotisakd P, Williams B, Connolly P, Shutt K, Hajjeh R, 2000. Factors associated with severe manifestations of histoplasmosis in AIDS. Clin Infect Dis 30 : 877–881. [Google Scholar]
  3. Zembrzuski MM, Bassanesi MC, Wagner LC, Severo LC, 1996. Inquérito intradérmico com histoplasmina e paracoccidiodina em duas regiões do Rio Grande do Sul. Rev Soc Bras Med Trop 29 : 1–3. [Google Scholar]
  4. Karimi K, Wheat LJ, Connolly P, Cloud G, Hajjeh R, Wheat E, Alves K, Lacaz S, Keath E, 2002. Differences in histoplasmosis in patients with acquired immunodeficiency syndrome in United States and Brazil. J Infect Dis 186 : 1655–1660. [Google Scholar]
  5. Cano MVC, Hejjeh RA, 2001. The epidemiology of histoplasmosis: a review. Semin Respir Infect 16 : 109–118. [Google Scholar]
  6. Hajjeh RA, 1995. Disseminated histoplasmosis in persons infected with human immunodeficiency virus. Clin Infect Dis 21 (Suppl 1): S108–S110. [Google Scholar]
  7. Couppie P, Sobesky M, Aznar C, Bichat S, Clyti E, Bissuel F, El Guedj M, Alvarez F, Demar M, Luovel D, Pradinaud R, Carme B, 2004. Histoplasmosis and acquired immunodeficiency syndrome: a study of prognostic factors. Clin Infect Dis 38 : 134–138. [Google Scholar]
  8. American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference, 1992. Definitions for sepsis and organ failure and guidelines for the need of innovative therapies in sepsis. Crit Care Med 20 : 864–874. [Google Scholar]
  9. Brady HR, Clarkson MR, Lieberthal W, 2004. Acute renal failure. Brenner BM, ed. Brenner and Rector’s The Kidney. Seventh edition. London: Elsevier, 1215–1292.
  10. Borges AS, Ferreira MS, Silvestre MTA, Nishioka SA, Rocha A, 1997. Histoplasmose em pacientes imunodeprimidos: estudo de 18 casos observados em Uberlândia, MG. Rev Soc Bras Med Trop 30 : 119–124. [Google Scholar]
  11. McKinsey DS, Spiegel RA, Hutwagner L, Stanford J, Driks MR, Brewer J, Gupta MR, Smith DL, O’Connor MC, Dall L, 1997. Prospective study of histoplasmosis in patients infected with human immunodeficiency virus: incidence, risk factors, and pathophysiology. Clin Infect Dis 24 : 1195–1203. [Google Scholar]
  12. Pietrobon D, 2004. Negro-Marquínez, Kilstein J, Galindez J, Greca A, Battagliotti. Histoplasmosis diseminada y sida en un hospital argentino: manifestaciones clínicas, diagnóstico y tratamiento. Enferm Infecc Microbiol Clin 22 : 156–159. [Google Scholar]
  13. Sarosi GA, Johnson PC, 1992. Disseminated histoplasmosis in patients infected with human immunodeficiency virus. Clin Infect Dis 14 (Suppl 1): S60–S67. [Google Scholar]
  14. Anonymous, 1997. Fever and renal failure in a 31-year-old male with AIDS. Am J Med 102 : 310–315. [Google Scholar]
  15. Burke DC, Emancipator SN, Smith MC, Salata RA, 1997. Histoplasmosis and kidney disease in patients with AIDS. Clin Infect Dis 25 : 281–284. [Google Scholar]
  16. Goswami RP, Pramanik N, Banerjee D, Raza MM, Guka SK, Maiti PK, 1999. Histoplasmosis in eastern India: the tip of the iceberg? Trans R Soc Trop Med Hyg 93 : 540–542. [Google Scholar]
  17. Nand N, Aggarwal HK, Singh M, Arora BR, Sen J, 2001. Renal failure in a case of histoplasmosis. J Assoc Physicians India 49 : 833–834. [Google Scholar]
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  • Received : 21 Sep 2005
  • Accepted : 15 Oct 2005

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