Challenges in the management of disseminated progressive histoplasmosis in human immunodeficiency virus-infected patients in resource-limited settings.

Challenges in the management of disseminated progressive histoplasmosis in human immunodeficiency virus-infected patients in resource-limited settings.
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DOI:
10.1093/ofid/ofv025
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发表时间:
2015-01
影响因子:
4.2
通讯作者:
Moosa MY
Moosa MY
中科院分区:
医学3区
文献类型:
--
作者:
Murphy RA;Gounder L;Manzini TC;Ramdial PK;Castilla C;Moosa MY

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组织胞浆菌病的诊断与人类免疫缺陷病毒在南部非洲的患者是复杂的非特异性的疾病介绍,在这个病人群体和敏感的诊断,包括抗原检测的不可用。治疗选择也受到限制,由于脂质体阿替西汀和伊曲康唑的不可用性,以及无法进行治疗药物监测进一步混淆管理。我们提出了3个临床病例,以说明在南部非洲的情况下,诊断和管理的局限性,我们强调需要额外的诊断工具和治疗方案,在资源有限的设置。
The diagnosis of histoplasmosis in patients with human immunodeficiency virus in southern Africa is complicated by the nonspecific presentation of the disease in this patient group and the unavailability of sensitive diagnostics including antigen assays. Treatment options are also limited due to the unavailability of liposomal amphotericin and itraconazole, and the inability to perform therapeutic drug monitoring further confounds management. We present 3 clinical cases to illustrate the limits of diagnosis and management in the southern African context, and we highlight the need for additional diagnostic tools and treatment options in resource-limited settings.
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