amphotericin-b and Communicable-Diseases--Imported

Topics: Amphotericin B; Animals; Antimony Sodium Gluconate; Antiprotozoal Agents; China; Communicable Diseases, Imported; DNA, Kinetoplast; Humans; Leishmaniasis, Cutaneous; Phosphorylcholine; Psychodidae

Topics: Amphotericin B; Animals; Antiprotozoal Agents; Communicable Diseases, Imported; Ear; Humans; Leishmania braziliensis; Leishmaniasis, Mucocutaneous; Male; Middle Aged; Phosphorylcholine; Travel

Topics: Amphotericin B; Antiprotozoal Agents; Child, Preschool; Communicable Diseases, Imported; Female; Humans; Leishmania tropica; Leishmaniasis, Cutaneous; Male; Travel-Related Illness

Histoplasmosis is a fungal infection caused by a dimorphic fungus, Histoplasma capsulatum. We report a first case of disseminated histoplasmosis in a 34-year-old woman, infected with human immunodeficiency virus (HIV), originating from Ivory Coast and living in Tunisia for 4 years. She was complaining from fever, chronic diarrhoea and pancytopenia. The Histoplasma capsulatum var. capsulatum was identified by direct microscopic examination of the bone marrow. She was treated by Amphotericin B, relayed by itraconazole. Even though a regression of symptoms and normalization of blood cell count (BCC), the patient died in a respiratory distress related to CMV hypoxemic pneumonia.

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Bone Marrow; Communicable Diseases, Imported; Cote d'Ivoire; Fatal Outcome; Female; Histoplasma; Histoplasmosis; HIV Infections; Humans; Itraconazole; Microscopy; Respiratory Distress Syndrome; Tunisia

A young, healthy traveler returning to the United States presented with fever, night sweats, splenomegaly, and pancytopenia. Bone marrow biopsy revealed leishmaniasis (Leishmania infantum), likely acquired in southern France. Although many cases of endemic visceral leishmaniasis (VL) have been reported in Europe, this is a rare case of imported VL in a healthy traveler returning from Europe to the US. Despite successful initial treatment with liposomal amphotericin B (LamB), relapse occurred. Treatments for VL in immunocompetent individuals are highly effective, but relapse can occur. There is more extensive experience in endemic areas with treating relapse that may be lacking in North America. This case alerts physicians in the US that immunocompetent adults can acquire VL during brief visits to endemic areas in Europe. It is important that travelers be counseled on preventive measures. Patients should be monitored after treatment for relapse.

Topics: Amphotericin B; Antiprotozoal Agents; Biopsy; Bone Marrow; Communicable Diseases, Imported; France; Humans; Leishmania infantum; Leishmaniasis, Visceral; Male; Recurrence; Travel; United States; Young Adult