A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIV
Disseminated histoplasmosis is a common differential diagnosis of tuberculosis in disease-endemic areas. We aimed to find a predictive score to orient clinicians towards disseminated histoplasmosis or tuberculosis when facing a non-specific infectious syndrome in patients with advanced HIV disease....
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/8/1/16 |
| _version_ | 1797492898923544576 |
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| author | Mathieu Nacher Kinan Drak Alsibai Loïc Epelboin Philippe Abboud Frédégonde About Magalie Demar Félix Djossou Romain Blaizot Maylis Douine Nadia Sabbah Nicolas Vignier Leila Adriouch Aude Lucarelli Mathilde Boutrou Pierre Couppié Antoine Adenis |
| author_facet | Mathieu Nacher Kinan Drak Alsibai Loïc Epelboin Philippe Abboud Frédégonde About Magalie Demar Félix Djossou Romain Blaizot Maylis Douine Nadia Sabbah Nicolas Vignier Leila Adriouch Aude Lucarelli Mathilde Boutrou Pierre Couppié Antoine Adenis |
| author_sort | Mathieu Nacher |
| collection | DOAJ |
| description | Disseminated histoplasmosis is a common differential diagnosis of tuberculosis in disease-endemic areas. We aimed to find a predictive score to orient clinicians towards disseminated histoplasmosis or tuberculosis when facing a non-specific infectious syndrome in patients with advanced HIV disease. We reanalyzed data from a retrospective study in Cayenne Hospital between January 1997–December 2008 comparing disseminated histoplasmosis and tuberculosis: 100 confirmed disseminated histoplasmosis cases and 88 confirmed tuberculosis cases were included. A simple logit regression model was constructed to predict whether a case was tuberculosis or disseminated histoplasmosis. From this model, a score may be obtained, where the natural logarithm of the probability of disseminated histoplasmosis/tuberculosis = +3.917962 × WHO performance score (1 if >2, 0 if ≤2) −1.624642 × Pulmonary presentation (1 yes, 0 no) +2.245819 × Adenopathies > 2 cm (1 yes, 0 no) −0.015898 × CD4 count − 0.001851 × ASAT − 0.000871 × Neutrophil count − 0.000018 × Platelet count + 6.053793. The area under the curve was 98.55%. The sensitivity of the model to distinguish between disseminated histoplasmosis and tuberculosis was 95% (95% CI = 88.7–98.3%), and the specificity was 93% (95% CI = 85.7.3–97.4%). In conclusion, we here present a clinical-biological predictive score, using simple variables available on admission, that seemed to perform very well to discriminate disseminated histoplasmosis from tuberculosis in French Guiana in well characterized patients. |
| first_indexed | 2024-03-10T01:11:18Z |
| format | Article |
| id | doaj.art-6c9f4d43ce5f46e3b3a99fbf4b4d9f81 |
| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T01:11:18Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-6c9f4d43ce5f46e3b3a99fbf4b4d9f812023-11-23T14:17:36ZengMDPI AGJournal of Fungi2309-608X2021-12-01811610.3390/jof8010016A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIVMathieu Nacher0Kinan Drak Alsibai1Loïc Epelboin2Philippe Abboud3Frédégonde About4Magalie Demar5Félix Djossou6Romain Blaizot7Maylis Douine8Nadia Sabbah9Nicolas Vignier10Leila Adriouch11Aude Lucarelli12Mathilde Boutrou13Pierre Couppié14Antoine Adenis15CIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaService d’anatomopathologie, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaService des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaService des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaService des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaLaboratoire Polyvalent, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaService des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaService de Dermatologie, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaCIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaService de Médecine, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaCIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaCoordination Régionale de la Lutte Contre le VIH et les Hépatites, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaCoordination Régionale de la Lutte Contre le VIH et les Hépatites, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaService des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaDépartement Formation Recherche, Université de Guyane, 97300 Cayenne, French GuianaCIC INSERM 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, French GuianaDisseminated histoplasmosis is a common differential diagnosis of tuberculosis in disease-endemic areas. We aimed to find a predictive score to orient clinicians towards disseminated histoplasmosis or tuberculosis when facing a non-specific infectious syndrome in patients with advanced HIV disease. We reanalyzed data from a retrospective study in Cayenne Hospital between January 1997–December 2008 comparing disseminated histoplasmosis and tuberculosis: 100 confirmed disseminated histoplasmosis cases and 88 confirmed tuberculosis cases were included. A simple logit regression model was constructed to predict whether a case was tuberculosis or disseminated histoplasmosis. From this model, a score may be obtained, where the natural logarithm of the probability of disseminated histoplasmosis/tuberculosis = +3.917962 × WHO performance score (1 if >2, 0 if ≤2) −1.624642 × Pulmonary presentation (1 yes, 0 no) +2.245819 × Adenopathies > 2 cm (1 yes, 0 no) −0.015898 × CD4 count − 0.001851 × ASAT − 0.000871 × Neutrophil count − 0.000018 × Platelet count + 6.053793. The area under the curve was 98.55%. The sensitivity of the model to distinguish between disseminated histoplasmosis and tuberculosis was 95% (95% CI = 88.7–98.3%), and the specificity was 93% (95% CI = 85.7.3–97.4%). In conclusion, we here present a clinical-biological predictive score, using simple variables available on admission, that seemed to perform very well to discriminate disseminated histoplasmosis from tuberculosis in French Guiana in well characterized patients.https://www.mdpi.com/2309-608X/8/1/16disseminated histoplasmosistuberculosisadvanced HIVpredictive score |
| spellingShingle | Mathieu Nacher Kinan Drak Alsibai Loïc Epelboin Philippe Abboud Frédégonde About Magalie Demar Félix Djossou Romain Blaizot Maylis Douine Nadia Sabbah Nicolas Vignier Leila Adriouch Aude Lucarelli Mathilde Boutrou Pierre Couppié Antoine Adenis A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIV Journal of Fungi disseminated histoplasmosis tuberculosis advanced HIV predictive score |
| title | A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIV |
| title_full | A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIV |
| title_fullStr | A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIV |
| title_full_unstemmed | A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIV |
| title_short | A Simple Predictive Score to Distinguish between Disseminated Histoplasmosis and Tuberculosis in Patients with HIV |
| title_sort | simple predictive score to distinguish between disseminated histoplasmosis and tuberculosis in patients with hiv |
| topic | disseminated histoplasmosis tuberculosis advanced HIV predictive score |
| url | https://www.mdpi.com/2309-608X/8/1/16 |
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