Received: July 21, 2008.

Accepted: October 20, 2008.

Abstract published online: October 31, 2008.

Full paper published online: May 30, 2009.

THE IMPORTANCE OF SEROLOGICAL ASSAYS IN DIAGNOSING ACUTE PULMONARY HISTOPLASMOSIS

Freitas RS (1), Carvalho-Vivi JO (2), Zamboni IM (2), Assis CM (3), Costa-Martins JE (1, 4), Vicentini-Moreira AP (2)

(1) Laboratory of Medical Mycology, Institute of Tropical Medicine, School of Medicine, University of São Paulo, São Paulo, São Paulo State, Brazil; (2) Laboratory of Mycosis Immunodiagnosis, Immunology Section, Adolfo Lutz Institute, São Paulo, São Paulo State, Brazil; (3) Basic Service Division, Adolfo Lutz Institute, São Paulo, São Paulo State, Brazil; (4) Department of Dermatology, School of Medicine, University of São Paulo, São Paulo, São Paulo State, Brazil.

ABSTRACT: Histoplasmosis is a systemic mycosis caused by inhalation of Histoplasma capsulatum microconidia. The disease does not normally affect immunocompetent individuals after a single, transient inhalation exposure. However, longer exposure may cause chronic or disseminated acute pulmonary infection. Herein, we report the case of a 24-year-old immunocompetent patient, who presented fever, cough and dyspnea for one month. The chest radiography revealed interstitial infiltrate and diffuse micronodules. The patient reported having had close and prolonged contact with bats. Diagnosis was confirmed by positive double immunodifusion and immunoblotting assays. She was treated with ketoconazole (400 mg) and there was complete resolution of the disease.

KEY WORDS: histoplasmosis, Histoplasma capsulatum, immunocompetence, serodiagnosis, bats.

CONFLICTS OF INTEREST: There is no conflict.

FINANCIAL SOURCE: Adolfo Lutz Institute, Disease Control Coordinatior, São Paulo State Secretary of Health.

CORRESPONDENCE TO:

ADRIANA PARDINI VICENTINI MOREIRA, Seção de Imunologia, Instituto Adolfo Lutz, Av. Dr. Arnaldo, 351, 11o andar, São Paulo, SP, 01246-902, Brasil. Phone: +55 11 3068 2899. Fax: +55 11 3068-2898. Email: apardini@ial.sp.gov.br.