Histoplasmosis in cancer patients: A global scoping review (2001–2024)

IF 2.2 4区医学 Q3 MYCOLOGY

Journal de mycologie medicale Pub Date : 2024-10-23 DOI:10.1016/j.mycmed.2024.101511

Asukwo E. Onukak , Chimaobi I. Nwagboso , Bernard B. Akpu , Agbo J. Etim , Ofonime E. Benjamin , Simon E. Ereh , Walter O. Egbara , Aje N. Ogar , Ekpenyong U. Essien , Bassey E. Ekeng

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引用次数: 0

Abstract

Although classified as an AIDS-defining illness, several reports show histoplasmosis also affects patients living with cancers including haematological malignancies and solid tumours. However, reviews describing cases of histoplasmosis in malignancies are lacking in the literature. We identified a total of thirty-four cases with twenty (58.8 %) cases reported from the USA, four from Brazil (11.8 %), three from India (8.8 %), and one each from Singapore (2.9 %), France (2.9 %), Netherlands (2.9 %), Colombia (2.9 %), Canada (2.9 %), Morocco (2.9 %), and Malaysia (2.9 %). 82.4 % (n = 28) of the cases were adults. Presenting symptoms were majorly fever (61.7 %), lymphadenopathy (50.0 %) and weight loss (29.4 %). Essential haematologic findings were pancytopaenia (n = 7, 20.6 %), neutropenia (n = 2, 5.9 %) and anaemia (n = 5, 14.7 %). The associated cancers were predominantly haematological and comprised 73.5 % (n = 25) of all cases. The diagnosis of histoplasmosis was via histopathology (n = 23, 67.6%), culture (n = 13, 38.2%), Histoplasma antigen assay (n = 13, 38.2%), anti-Histoplasma antibody assay (n = 5, 14.7%), PCR and sequencing (n = 2, 5.9%), peripheral blood film/direct microscopy (n = 4, 11.8%) and cytology (n = 1, 2.9%). Of the thirty-four cases, twenty-four (70.6%) had favourable outcomes, eight (23.5%) died, one (2.9%) was lost to follow-up and in one (2.9%) case, the outcome was not stated. Histoplasmosis is not an uncommon opportunistic disease complicating malignancies but is paradoxically underdiagnosed in Africa given the huge burden of cancers in that region. Besides following chemotherapy and the use of steroids, tumour necrosis factor-α antagonists therapy, hematopoietic stem cell transplantation and environmental exposure were factors associated with Histoplasma infection in patients with malignancies. A resolution to promptly screen suspected or confirmed cases of malignancies for histoplasmosis will improve diagnosis and clinical outcomes.

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癌症患者中的组织胞浆菌病：全球范围审查（2001-2024 年）

虽然组织胞浆菌病被归类为艾滋病定义疾病，但一些报告显示，组织胞浆菌病也会影响癌症患者，包括血液恶性肿瘤和实体瘤患者。然而，文献中缺乏描述恶性肿瘤中组织胞浆菌病病例的综述。我们共发现了 34 例病例，其中 20 例（58.8%）来自美国，4 例来自巴西（11.8%），3 例来自印度（8.8%），新加坡（2.9%）、法国（2.9%）、荷兰（2.9%）、哥伦比亚（2.9%）、加拿大（2.9%）、摩洛哥（2.9%）和马来西亚（2.9%）各 1 例。82.4%的病例（n = 28）为成人。主要表现为发热（61.7%）、淋巴结肿大（50.0%）和体重减轻（29.4%）。主要的血液学检查结果为泛发性血小板减少（7 例，20.6%）、中性粒细胞减少（2 例，5.9%）和贫血（5 例，14.7%）。伴发的癌症主要是血液肿瘤，占所有病例的 73.5%（n = 25）。组织胞浆菌病的诊断方法包括组织病理学（23 例，67.6%）、培养（13 例，38.2%）、组织胞浆菌抗原检测（13 例，38.2%）、抗组织胞浆菌抗体检测（5 例，14.7%）、PCR 和测序（2 例，5.9%）、外周血片/直接显微镜检查（4 例，11.8%）和细胞学检查（1 例，2.9%）。在 34 例病例中，24 例（70.6%）结果良好，8 例（23.5%）死亡，1 例（2.9%）失去随访，1 例（2.9%）未说明结果。组织胞浆菌病是一种并发于恶性肿瘤的罕见机会性疾病，但在非洲却诊断不足，这与该地区巨大的癌症负担有关。除了化疗和使用类固醇外，肿瘤坏死因子-α拮抗剂治疗、造血干细胞移植和环境暴露也是恶性肿瘤患者感染组织胞浆菌的相关因素。及时对疑似或确诊的恶性肿瘤病例进行组织胞浆菌病筛查将改善诊断和临床效果。

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来源期刊

Journal de mycologie medicale 医学-真菌学

CiteScore

5.10

自引率

2.80%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal de Mycologie Medicale / Journal of Medical Mycology (JMM) publishes in English works dealing with human and animal mycology. The subjects treated are focused in particular on clinical, diagnostic, epidemiological, immunological, medical, pathological, preventive or therapeutic aspects of mycoses. Also covered are basic aspects linked primarily with morphology (electronic and photonic microscopy), physiology, biochemistry, cellular and molecular biology, immunochemistry, genetics, taxonomy or phylogeny of pathogenic or opportunistic fungi and actinomycetes in humans or animals. Studies of natural products showing inhibitory activity against pathogenic fungi cannot be considered without chemical characterization and identification of the compounds responsible for the inhibitory activity. JMM publishes (guest) editorials, original articles, reviews (and minireviews), case reports, technical notes, letters to the editor and information. Only clinical cases with real originality (new species, new clinical present action, new geographical localization, etc.), and fully documented (identification methods, results, etc.), will be considered. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. The journal is indexed in the main international databases and is accessible worldwide through the ScienceDirect and ClinicalKey platforms.