Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana
We aimed to describe the ways patients with disseminated histoplasmosis—a multifaceted and often lethal disease—present themselves and are explored. A retrospective, observational, multicentric study spanned the period between 1 January 1981 and 1 October 2014. Principal component analysis was perfo...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-09-01
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| Series: | Journal of Fungi |
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| Online Access: | https://www.mdpi.com/2309-608X/6/3/165 |
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| author | Mathieu Nacher Audrey Valdes Antoine Adenis Romain Blaizot Philippe Abboud Magalie Demar Félix Djossou Loïc Epelboin Kinan Drak Alsibai Caroline Misslin Balthazar Ntab Pierre Couppié |
| author_facet | Mathieu Nacher Audrey Valdes Antoine Adenis Romain Blaizot Philippe Abboud Magalie Demar Félix Djossou Loïc Epelboin Kinan Drak Alsibai Caroline Misslin Balthazar Ntab Pierre Couppié |
| author_sort | Mathieu Nacher |
| collection | DOAJ |
| description | We aimed to describe the ways patients with disseminated histoplasmosis—a multifaceted and often lethal disease—present themselves and are explored. A retrospective, observational, multicentric study spanned the period between 1 January 1981 and 1 October 2014. Principal component analysis was performed for the sampling sites and for the clinical signs and symptoms. The factor loadings of the principal components were selected for eigenvalues > 1. The most frequent signs and symptoms were an alteration of the WHO general performance status, fever, digestive tract, respiratory signs and symptoms and lymphadenopathies. The most common sites sampled were bone marrow, respiratory tract, blood, lymph node and liver biopsies, with significant variations in the number of sites from which samples were taken to try to identify the pathogen. The principal component analysis clinical signs and symptoms leading to the diagnosis showed four main lines of variation. The factor loadings of the four main components were compatible with four broad types of clinical presentations and four types of exploration strategies. Extracting simple algorithms was difficult, emphasizing the importance of clinical expertise when diagnosis depends on obtaining a sample where Histoplasma can be seen or grown. <i>Histoplasma</i> antigen detection tests will help simplifying the algorithms. |
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| institution | Directory Open Access Journal |
| issn | 2309-608X |
| language | English |
| last_indexed | 2024-03-10T16:29:50Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Fungi |
| spelling | doaj.art-98ac89db0bb447a7a1320d5c615c48d42023-11-20T12:56:37ZengMDPI AGJournal of Fungi2309-608X2020-09-016316510.3390/jof6030165Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French GuianaMathieu Nacher0Audrey Valdes1Antoine Adenis2Romain Blaizot3Philippe Abboud4Magalie Demar5Félix Djossou6Loïc Epelboin7Kinan Drak Alsibai8Caroline Misslin9Balthazar Ntab10Pierre Couppié11CIC INSERM 1424, Centre Hospitalier Andree Rosemon Cayenne, 97300 Cayenne, French GuianaEquipe Opérationnelle d’Hygiène Hospitalière, Centre Hospitalier Andree Rosemon Cayenne, 97300 Cayenne, French GuianaCIC INSERM 1424, Centre Hospitalier Andree Rosemon Cayenne, 97300 Cayenne, French GuianaDépartement Formation Recherche Santé, Université de Guyane, 97300 Cayenne, French GuianaService des Maladies Infectieuses et Tropicales, Centre Hospitalier Andree Rosemon Cayenne, 97300 Cayenne, French GuianaLaboratory, Centre Hospitalier Andree Rosemon Cayenne, 97300 Cayenne, French GuianaService des Maladies Infectieuses et Tropicales, Centre Hospitalier Andree Rosemon Cayenne, 97300 Cayenne, French GuianaService des Maladies Infectieuses et Tropicales, Centre Hospitalier Andree Rosemon Cayenne, 97300 Cayenne, French GuianaService d’Anatomopathologie, Centre Hospitalier Andree Rosemon Cayenne, 97300 Cayenne, French GuianaService de Médecine, Centre Hospitalier de l’Ouest Guyanais, 97320 Saint Laurent du Maroni, French GuianaDépartement d’Information Médicale, Centre Hospitalier de l’Ouest Guyanais, 97320 Saint Laurent du Maroni, French GuianaDépartement Formation Recherche Santé, Université de Guyane, 97300 Cayenne, French GuianaWe aimed to describe the ways patients with disseminated histoplasmosis—a multifaceted and often lethal disease—present themselves and are explored. A retrospective, observational, multicentric study spanned the period between 1 January 1981 and 1 October 2014. Principal component analysis was performed for the sampling sites and for the clinical signs and symptoms. The factor loadings of the principal components were selected for eigenvalues > 1. The most frequent signs and symptoms were an alteration of the WHO general performance status, fever, digestive tract, respiratory signs and symptoms and lymphadenopathies. The most common sites sampled were bone marrow, respiratory tract, blood, lymph node and liver biopsies, with significant variations in the number of sites from which samples were taken to try to identify the pathogen. The principal component analysis clinical signs and symptoms leading to the diagnosis showed four main lines of variation. The factor loadings of the four main components were compatible with four broad types of clinical presentations and four types of exploration strategies. Extracting simple algorithms was difficult, emphasizing the importance of clinical expertise when diagnosis depends on obtaining a sample where Histoplasma can be seen or grown. <i>Histoplasma</i> antigen detection tests will help simplifying the algorithms.https://www.mdpi.com/2309-608X/6/3/165disseminated histoplasmosisHIVdiagnosisclinical presentationpolymorphismFrench Guiana |
| spellingShingle | Mathieu Nacher Audrey Valdes Antoine Adenis Romain Blaizot Philippe Abboud Magalie Demar Félix Djossou Loïc Epelboin Kinan Drak Alsibai Caroline Misslin Balthazar Ntab Pierre Couppié Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana Journal of Fungi disseminated histoplasmosis HIV diagnosis clinical presentation polymorphism French Guiana |
| title | Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana |
| title_full | Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana |
| title_fullStr | Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana |
| title_full_unstemmed | Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana |
| title_short | Heterogeneity of Clinical Presentations and Paraclinical Explorations to Diagnose Disseminated Histoplasmosis in Patients with Advanced HIV: 34 Years of Experience in French Guiana |
| title_sort | heterogeneity of clinical presentations and paraclinical explorations to diagnose disseminated histoplasmosis in patients with advanced hiv 34 years of experience in french guiana |
| topic | disseminated histoplasmosis HIV diagnosis clinical presentation polymorphism French Guiana |
| url | https://www.mdpi.com/2309-608X/6/3/165 |
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