Prevalence of Histoplasmosis and Molecular Characterization of Histoplasma species in Patients with Presumptive Pulmonary Tuberculosis in Calabar, Nigeria.
Prevalence of Histoplasmosis and Molecular Characterization of Histoplasma species in Patients with Presumptive Pulmonary Tuberculosis in Calabar, Nigeria.
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DOI：
10.1093/ofid/ofac368
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发表时间：
2022-08
影响因子：
4.2
通讯作者：
中科院分区：
文献类型：
--
作者：
文献中大量报道了组织胞浆菌病误诊为结核病的病例。尼日利亚是结核病负担最重的国家之一，但文献中关于尼日利亚组织胞浆菌病的数据很少。本研究的目的是调查尼日利亚卡拉巴尔推定肺结核患者的组织胞浆菌病。这是一项描述性横断面研究，对2020年4月至2021年3月期间推定诊断为肺结核的213名参与者进行了研究。收集患者尿液标本，采用酶免疫试剂盒进行组织浆体抗原检测；收集痰标本，采用GeneXpert检测结核确诊，采用常规聚合酶链反应（PCR）诊断组织浆菌病。在纳入研究的213名参与者中，94名（44.1%）被确诊为结核病患者，75名（35.2%）为人类免疫缺陷病毒（HIV）阳性，41名（19.2%）为晚期HIV疾病（AHD）， 138名（64.8%）为HIV阴性。213名参与者中有27人通过抗原检测和/或PCR呈组织浆体阳性，总体患病率为12.7%。确诊结核患者组织胞浆菌病患病率（7.4%[7/94]）显著低于未确诊结核患者（16.8% [20/119]）（P = 0.04）。接受抗结核治疗的参与者与未接受抗结核药物治疗的参与者相比，组织胞浆菌病的发病率也显著降低（P = 0.006）。组织浆体的内部转录间隔序列（ITS）测序显示其与荚膜组织浆体有密切的亲缘关系。组织胞浆菌病在推定结核病患者中并不罕见。应对出现结核症状的患者进行适当的微生物学调查，以排除组织胞浆菌病病例。
Several case reports abound in literature about cases of histoplasmosis misdiagnosed as tuberculosis (TB). Nigeria is one of the highest TB-burdened countries, but data on histoplasmosis in Nigeria are sparse in the literature. The aim of this research was to investigate patients with presumptive pulmonary TB in Calabar, Nigeria, for histoplasmosis. This was a descriptive cross-sectional study of 213 participants with presumptive diagnosis of pulmonary TB between April 2020 and March 2021. Urine samples were collected from selected patients for Histoplasma antigen test using enzyme immunoassay kits, while sputum samples were collected for GeneXpert test for confirmed diagnosis of TB and conventional polymerase chain reaction (PCR) for the diagnosis of histoplasmosis. Of the 213 participants enrolled into the study, 94 subjects (44.1%) were confirmed TB patients, 75 (35.2%) were human immunodeficiency virus (HIV) positive, 41 (19.2%) had advanced HIV disease (AHD), and 138 (64.8%) were HIV negative. Twenty-seven of the 213 participants were Histoplasma positive by antigen test and/or PCR, giving an overall prevalence rate of 12.7%. The prevalence of histoplasmosis among confirmed TB patients (7.4% [7/94]) was significantly lower than in unconfirmed TB patients (16.8% [20/119]) (P = .04). Participants on anti-TB therapy also had a significantly lower rate of histoplasmosis compared to those not on anti-TB drugs (P = .00006). The internal transcribed spacer (ITS) sequencing of the Histoplasma revealed a closely relatedness to Histoplasma capsulatum. Histoplasmosis is not uncommon among presumptive TB patients. There should be proper microbiological investigation of patients presenting with symptoms suggestive of TB to exclude cases of histoplasmosis.
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DOI：
10.1016/j.trstmh.2012.05.009
发表时间：
2012-08-01
影响因子：
2.2
作者：
Lofgren, Sarah M.;Kirsch, Emily J.;Crump, John A.
通讯作者：
Crump, John A.
影响因子：
5.7
作者：
Ekeng BE;Edem K;Akintan P;Oladele RO
通讯作者：
Oladele RO
影响因子：
4.7
作者：
Ekeng, Bassey E.;Davies, Adeyinka A.;Osaigbovo, Iriagbonse I.;Warris, Adilia;Oladele, Rita O.;Denning, David W.
通讯作者：
Denning, David W.
影响因子：
9.4
作者：
Bracca, A;Tosello, ME;Serra, E
通讯作者：
Serra, E
影响因子：
10.7
作者：
SAITOU, N;NEI, M
通讯作者：
NEI, M