{"title":"组织胞浆菌病住院患者的特征和结局:免疫功能低下和非免疫功能低下成人患者的比较","authors":"Liam M Dalton, Carol A Kauffman, Marisa H Miceli","doi":"10.3390/jof11090671","DOIUrl":null,"url":null,"abstract":"<p><p>We sought to investigate the role of immunocompromise in patients with newly diagnosed histoplasmosis in an era when AIDS is less prevalent. We performed a retrospective comparison of immunocompromised and non-immunocompromised adults hospitalized at Michigan Medicine from 2015 to 2024. Of 51 patients, 37 (73%) were immunocompromised, 32 from solid organ transplantation or tumor necrosis factor antagonist/disease-modifying anti-rheumatic drugs. Of these 37, 34 had disseminated and 3 had pulmonary histoplasmosis; of the 14 non-immunocompromised patients, 8 had disseminated and 6 had pulmonary histoplasmosis, <i>p</i> = 0.004. Fever was the only symptom/sign that was more common in the immunocompromised cohort (86% vs. 36%, <i>p</i> = 0.003). Laboratory/radiological studies showed no major differences between immunocompromised and non-immunocompromised cohorts. <i>Histoplasma</i> urinary antigen was positive for all immunocompromised vs. 79% non-immunocompromised patients, <i>p</i> = 0.003. Median antigen levels were 17.5 (IQR 6.2-19.7) ng/mL for immunocompromised vs. 1.9 (0.6-19.7) ng/mL for non-immunocompromised patients, <i>p</i> = 0.004. Cultures for <i>Histoplasma</i> were more often positive in the immunocompromised cohort, <i>p</i> = 0.025. All-cause 90-day mortality was 14% in each cohort (five immunocompromised and two non-immunocompromised patients); all deaths occurred in those with disseminated histoplasmosis, and four were in the first week of hospitalization. Disseminated histoplasmosis in both immunocompromised and non-immunocompromised patients continues to be a serious, often fatal infection.</p>","PeriodicalId":15878,"journal":{"name":"Journal of Fungi","volume":"11 9","pages":""},"PeriodicalIF":4.2000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470927/pdf/","citationCount":"0","resultStr":"{\"title\":\"Characteristics and Outcomes of Hospitalized Patients with Histoplasmosis: Comparison of Immunocompromised and Non-Immunocompromised Adult Patients.\",\"authors\":\"Liam M Dalton, Carol A Kauffman, Marisa H Miceli\",\"doi\":\"10.3390/jof11090671\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>We sought to investigate the role of immunocompromise in patients with newly diagnosed histoplasmosis in an era when AIDS is less prevalent. We performed a retrospective comparison of immunocompromised and non-immunocompromised adults hospitalized at Michigan Medicine from 2015 to 2024. Of 51 patients, 37 (73%) were immunocompromised, 32 from solid organ transplantation or tumor necrosis factor antagonist/disease-modifying anti-rheumatic drugs. Of these 37, 34 had disseminated and 3 had pulmonary histoplasmosis; of the 14 non-immunocompromised patients, 8 had disseminated and 6 had pulmonary histoplasmosis, <i>p</i> = 0.004. Fever was the only symptom/sign that was more common in the immunocompromised cohort (86% vs. 36%, <i>p</i> = 0.003). Laboratory/radiological studies showed no major differences between immunocompromised and non-immunocompromised cohorts. <i>Histoplasma</i> urinary antigen was positive for all immunocompromised vs. 79% non-immunocompromised patients, <i>p</i> = 0.003. Median antigen levels were 17.5 (IQR 6.2-19.7) ng/mL for immunocompromised vs. 1.9 (0.6-19.7) ng/mL for non-immunocompromised patients, <i>p</i> = 0.004. Cultures for <i>Histoplasma</i> were more often positive in the immunocompromised cohort, <i>p</i> = 0.025. All-cause 90-day mortality was 14% in each cohort (five immunocompromised and two non-immunocompromised patients); all deaths occurred in those with disseminated histoplasmosis, and four were in the first week of hospitalization. Disseminated histoplasmosis in both immunocompromised and non-immunocompromised patients continues to be a serious, often fatal infection.</p>\",\"PeriodicalId\":15878,\"journal\":{\"name\":\"Journal of Fungi\",\"volume\":\"11 9\",\"pages\":\"\"},\"PeriodicalIF\":4.2000,\"publicationDate\":\"2025-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12470927/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Fungi\",\"FirstCategoryId\":\"99\",\"ListUrlMain\":\"https://doi.org/10.3390/jof11090671\",\"RegionNum\":2,\"RegionCategory\":\"生物学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MICROBIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Fungi","FirstCategoryId":"99","ListUrlMain":"https://doi.org/10.3390/jof11090671","RegionNum":2,"RegionCategory":"生物学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MICROBIOLOGY","Score":null,"Total":0}
Characteristics and Outcomes of Hospitalized Patients with Histoplasmosis: Comparison of Immunocompromised and Non-Immunocompromised Adult Patients.
We sought to investigate the role of immunocompromise in patients with newly diagnosed histoplasmosis in an era when AIDS is less prevalent. We performed a retrospective comparison of immunocompromised and non-immunocompromised adults hospitalized at Michigan Medicine from 2015 to 2024. Of 51 patients, 37 (73%) were immunocompromised, 32 from solid organ transplantation or tumor necrosis factor antagonist/disease-modifying anti-rheumatic drugs. Of these 37, 34 had disseminated and 3 had pulmonary histoplasmosis; of the 14 non-immunocompromised patients, 8 had disseminated and 6 had pulmonary histoplasmosis, p = 0.004. Fever was the only symptom/sign that was more common in the immunocompromised cohort (86% vs. 36%, p = 0.003). Laboratory/radiological studies showed no major differences between immunocompromised and non-immunocompromised cohorts. Histoplasma urinary antigen was positive for all immunocompromised vs. 79% non-immunocompromised patients, p = 0.003. Median antigen levels were 17.5 (IQR 6.2-19.7) ng/mL for immunocompromised vs. 1.9 (0.6-19.7) ng/mL for non-immunocompromised patients, p = 0.004. Cultures for Histoplasma were more often positive in the immunocompromised cohort, p = 0.025. All-cause 90-day mortality was 14% in each cohort (five immunocompromised and two non-immunocompromised patients); all deaths occurred in those with disseminated histoplasmosis, and four were in the first week of hospitalization. Disseminated histoplasmosis in both immunocompromised and non-immunocompromised patients continues to be a serious, often fatal infection.
期刊介绍:
Journal of Fungi (ISSN 2309-608X) is an international, peer-reviewed scientific open access journal that provides an advanced forum for studies related to pathogenic fungi, fungal biology, and all other aspects of fungal research. The journal publishes reviews, regular research papers, and communications in quarterly issues. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on paper length. Full experimental details must be provided so that the results can be reproduced.