Disseminated histoplasmosis in patients with AIDS

S. D. Nightingale, J. M. Parks, S. M. Pounders, D. K. Burns, J. Reynolds, J. A. Hernandez

Research output: Contribution to journalArticle

52 Scopus citations

Abstract

Disseminated histoplasmosis was diagnosed in 36 (4%) of 980 patients with AIDS seen at Parkland Memorial Hospital in Dallas, Texas before September 30, 1989. Diagnostic sensitivity of blood culture plus examination of peripheral smear was 88%; sensitivity of bone marrow aspiration and blood culture was 80%. Median CD4 lymphocyte count at diagnosis was 33/cu mm. Median actuarial survival from the date histoplasmosis was diagnosed was 188 days. Thirteen (36%) of the 36 patients died before adequate antifungal therapy could be administered, while 13 survived long enough to receive 1,500 mg of amphotericin B; actuarial survival of the latter group from the date 1,500 mg of amphotericin B had been infused was 47% at 1 year. The substantial early mortality of AIDS-associated disseminated histoplasmosis and the modestly encouraging survival of those who were diagnosed in time to receive adequate therapy raise the issues of surveillance, prophylaxis, and empiric therapy for this infection in selected HIV-positive patients.

Original languageEnglish (US)
Pages (from-to)624-630
Number of pages7
JournalSouthern medical journal
Volume83
Issue number6
DOIs
StatePublished - Jun 1990

ASJC Scopus subject areas

  • Medicine(all)

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    Nightingale, S. D., Parks, J. M., Pounders, S. M., Burns, D. K., Reynolds, J., & Hernandez, J. A. (1990). Disseminated histoplasmosis in patients with AIDS. Southern medical journal, 83(6), 624-630. https://doi.org/10.1097/00007611-199006000-00007