Histoplasmosis, an
infection caused by the fungus Histoplasma capsulatum, has been reported all over the world and is considered endemic in the American continent, including Cuba. This fungus grows on the
soils contaminated with bird and bat excreta, where it produces a great number of microconidia that could cause the
infection when they are inhaled. The clinical spectrum varies from
asymptomatic infections to serious disseminated diseases involving one or many organ systems and affects mainly
AIDS patients, patients with hematological
neoplasias, transplant recipients or other immunosuppressed patients. The main risk groups include those individuals whose working activities make them be exposed to
aerosols contaminated with H. capsulatum. Lab diagnosis is based on the microscopic observation, isolation and identification of the fungus in fluid or tissue samples of patients, and on specific
antigen and
antibodies detection. The molecular methods based on polymerase chain reaction have not been sufficiently defined, and they could be an important advance in the early diagnosis of this mycosis.
Itraconazole is recommended for treatment of moderate, localized and
chronic infection whereas
amphotericin B is the
drug of choice for disseminated and serious manifestations, particularly in its lipidic formulations. At present,
histoplasmosis is considered one of the most important systemic
mycoses in the Americas, and it is widely spread over all regions of Cuba.