Histoplasmosis and paracoccidioidomycosis in a non-endemic area: a review of cases and diagnosis.

摘要: Background. Histoplasmosis and paracoccidioidomycosis (PCM) have increased in Spain recent years, due firstly to the migration from endemic regions secondly travelers returning these regions. In non-endemic areas, diagnosis of both diseases is hampered by lack experience, long silent periods, resemblance other such as tuberculosis sarcoidosis. Methods. A total 39 cases imported histoplasmosis 6 PCM diagnosed Spanish Mycology Reference Laboratory since 2006 were analyzed. Microbiological was performed using classical methods also a specific real-time polymerase chain reaction (RT-PCR) assay for each microorganism. Results. We had 9 probable 30 immigrants, 29 whom defined proven. Paracoccidioidomycosis either immigrants or people who lived period time regions, all classified proven cases. Cultures showed good sensitivity detecting Histoplasma capsulatum with (73%); however, growth very slow. The fungus never recovered traveler patients. Paracoccidioides brasiliensis isolated culture only one case PCM. Serological not reliable immunocompromized patients (40%). PCR-based technique detected 55.5% (probable cases) 89% (proven). PCR method 100% cases. Conclusions. These kinds mycoses are increasingly frequent newer faster techniques should be used reach an early diagnosis. RT-PCR developed appear sensitive, specific, fast could helpful detect those mycoses. However, it essential that physicians perform differential individuals coming areas.