Abstract
The buffy coat is obtained routinely for disseminated histoplamosis (DH) diagnosis in Ceará, Brazil. The aim of this study is to describe the accuracy of staining smears for Histoplasma in the buffy coat of AIDS-patients with DH. From 2012–2013, all results of stained buffy coat smears and culture for fungi performed at São José Hospital were recorded. In total, 489 buffy coats of 361 patients were studied; 19/361 (5.3%; 95%CI = 2.9–7.6%) had positive direct examination stained smears for Histoplasma and 61/361 (16.9%; 95%CI = 13.0–20.8%) had growth in culture. For those with positive Histoplasma cultures, the CD4 count was significantly lower (139.3 vs. 191.7cells/µL; p = 0.014) than others, and death was 18%. The sensitivity and specificity of stained smears was 25.9% and 100%, respectively. A second test, performed up to 36 days from the first one, increased the sensitivity of stained smears to 32.2%. Stained smears of buffy coat have low accuracy; nonetheless, they are easy to perform and can give a quick diagnosis in low-resource endemic areas. Despite the decrease in mortality, it is not yet to the low levels observed in areas that have better and more efficient methods.
Highlights
Histoplasmosis is a widely distributed disease caused by the dimorphic fungus Histoplasma capsulatum [1]
The aim of this study is to describe the experience of the São José Hospital using buffy coat as a diagnostic tool for disseminated histoplamosis (DH) in HIV-patients, and to determine the sensitivity and specificity of this test in that specific population
Study Population and Research Design. This was a cross-sectional study conducted at Hospital São José, a public infectious diseases reference hospital for the HIV-positive population of Ceará State, in Northeastern Brazil
Summary
Histoplasmosis is a widely distributed disease caused by the dimorphic fungus Histoplasma capsulatum [1]. It is considered the most common endemic mycosis in the United States and in certain areas of Mexico and Central and South America [1,2]. Two varieties of H. capsulatum are known: var capsulatum and var duboisii. Both are indistinguishable in their mycelian form, but differ in their yeast; in var duboisii (restrict to the tropical areas of Africa), the cells have thicker walls and are larger, not seen inside leukocytes as the var capsulatum [3]. In Ceará state, located in northeastern Brazil, DH is an important cause of
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
