Evidence map›Paper›PMID 33819269›Full record

ArticlePLoS neglected tropical diseases2021

High prevalence and mortality due to Histoplasma capsulatum in the Brazilian Amazon: An autopsy study.

Natalia Rakislova, Juan Carlos Hurtado, Antonio E M Palhares, Luiz Ferreira, Monique Freire, Marcus Lacerda, Wuelton Monteiro, Mireia Navarro, Isaac Casas, Marcus de Melo Teixeira and 14 more

Open access · goldAbstract read
In one paragraph

Article in PLoS neglected tropical diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 20 citations in OpenAlex.

  1. Observational
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Review
  8. Review
  9. Molecular Detection ofTransboundary and emerging diseases · 2023
    Article
  10. Molecular Diagnosis of Endemic Mycoses.Journal of fungi (Basel, Switzerland) · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

24 authors at 7 institutions in 4 countries.

Natalia RakislovaISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0001-5030-3526
Juan Carlos HurtadoISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0001-9519-6082
Antonio E M PalharesUniversidade do Estado do Amazonas, Manaus, Brazil.ORCID 0000-0001-9409-7322
Luiz FerreiraFundação de Medicina Tropical Doutor Heitor Viera Dourado, Manaus, Brazil.ORCID 0000-0002-9657-939X
Monique FreireUniversidade do Estado do Amazonas, Manaus, Brazil.ORCID 0000-0001-7849-6112
Marcus LacerdaFundação de Medicina Tropical Doutor Heitor Viera Dourado, Manaus, Brazil.ORCID 0000-0003-3374-9985
Wuelton MonteiroUniversidade do Estado do Amazonas, Manaus, Brazil.
Mireia NavarroISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Isaac CasasISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Marcus de Melo TeixeiraThe Pathogen and Microbiome Institute, Northern Arizona University, Flagstaff, Arizona, United States of America.ORCID 0000-0003-1763-3464
Paola CastilloISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0002-9284-8601
Maria Teresa Rodrigo-CalvoDepartment of Pathology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0001-6675-3425
Lorena MarimonISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0002-2943-3550
José GuerreroDepartment of Pathology, Hospital Clinic of Barcelona, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0002-8589-5936
Rosauro VaroISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Vima DelgadoISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Llorenç QuintóISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0001-9992-6951
Francesc MarcoISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0002-1863-6379
Emilio LetangISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0002-9970-1880
Jordi VilaISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0002-8025-3926
Quique BassatISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0003-0875-7596
Clara MenéndezISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
Jaume OrdiISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0002-4820-7954
Miguel J MartínezISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.ORCID 0000-0002-0682-1075
Barcelona Institute for Global Health · ESFundação de Medicina Tropical · BRUniversitat de Barcelona · ESInstitució Catalana de Recerca i Estudis Avançats · ESManhiça Health Research Centre · MZUniversidade de Brasília · BRUniversidade do Estado do Amazonas · BR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHistoplasmosis is acquired by inhalation of spores of the dimorphic fungus Histoplasma spp. Although this pathogen is distributed worldwide, it is more prevalent in the Americas. However, the real burden of histoplasmosis remains undefined in many endemic regions. METHODOLOGY: We conducted a series of 61 autopsies to individuals who died in a hospital in the Brazilian Amazon focused on infectious diseases. We performed a detailed histological and microbiological evaluation with genetic characterization of Histoplasma strains with the aim to evaluate the contribution of histoplasmosis to morbidity and mortality. Additionally, we assessed the clinicopathological correlation. PRINCIPAL

findingsEvidence of Histoplasma infection was detected in 21 patients (34%). Eight cases were disseminated infections, all of them occurred in HIV-positive patients. Six cases were localized histoplasmosis, limited to the lungs. In seven patients Histoplasma DNA was detected by PCR in patients with no histological lesions. Histoplasma infection was detected in 38% of HIV-positive patients and was a major contributor to death in 22% of them. Lungs, liver and spleen were affected in all cases of disseminated histoplasmosis. Phylogenetic analysis of the strains suggested a high diversity of Histoplasma species circulating in the Brazilian Amazon. Histoplasmosis was clinically missed in 75% of the disseminated infections.

conclusionsThe high incidence of histoplasmosis, the low index of clinical suspicion, and the severity of the disseminated disease highlight the need of proactively implementing sensitive routine screening methods for this pathogen in endemic areas. Antifungal prophylaxis against Histoplasma should be encouraged in the severely immunocompromised HIV patients in these areas. In conclusion, substantial mortality is associated with disseminated histoplasmosis among HIV-positive patients in the Brazilian Amazon.

Indexed as

AdolescentAdultAgedAged, 80 and overAIDS-Related Opportunistic InfectionsAutopsyBrazilFemaleHistoplasmaHistoplasmosisHumansMaleMiddle AgedPhylogenyPrevalenceYoung Adult

Identifiers

PMID33819269
PMCPMC8049479
OpenAlexW3140105143

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.