{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:19:57Z","timestamp":1790774397387,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Differently from immunocompromised patients, very little information is available in the literature regarding the clinical presentation, epidemiology, and outcomes of histoplasmosis in non-immunosuppressed individuals living in endemic areas. This retrospective case series study was carried out by reviewing the medical records of non-immunocompromised patients with histoplasmosis, residents in a hyperendemic area in northeastern Brazil, between 2011 and 2022. Thirty HIV-negative patients were identified with histoplasmosis, and 19 cases met the inclusion criteria: three had acute, five subacute and one chronic pulmonary forms; two with mediastinal picture and eight had disseminated disease (two with severe symptoms). The median age of our sample was 32.7 years old [interquartile range: 24\u201345]. Most of the patients were male (male-to-female ratio\u00a0=\u00a015:4) and resided in the state capital (n\u00a0=\u00a09). The majority had a previous history of exposure to well-known risk factors for Histoplasma infection. Pulmonary nodules were observed in all subacute form, two patients (acute and subacute forms) were initially treated empirically for pulmonary tuberculosis; one death was registered in the subacute form. The chronic pulmonary form of histoplasmosis was diagnosed in one patient only after the symptoms persisted despite specific treatment. The primary clinical manifestations of the moderate form of DH were enlarged lymph nodes, with histopathology being the main diagnostic method. The cases were detected as isolated occurrences and not as an outbreak, suggesting that exposure to Histoplasma can be more widespread than presumed. Despite the self-limiting nature of the disease, death can occur even in previously heathy patients.<\/jats:p>","DOI":"10.1093\/mmy\/myae059","type":"journal-article","created":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T08:02:12Z","timestamp":1720252932000},"source":"Crossref","is-referenced-by-count":5,"title":["Histoplasmosis in non-immunosuppressed patients from an endemic area in Northeastern Brazil"],"prefix":"10.1093","volume":"62","author":[{"suffix":"PhD","given":"Terezinha do Menino Jesus Silva","family":"Leit\u00e3o","sequence":"first","affiliation":[{"name":"Universidade Federal do Cear\u00e1, Faculdade de Medicina, Departamento de Sa\u00fade Comunit\u00e1ria , Postal code 60441-750, Fortaleza, Cear\u00e1 , Brazil"},{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas , Postal code 60455-610, Fortaleza, Cear\u00e1 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"MD","given":"Nina Brunet Saraiva","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas , Postal code 60455-610, Fortaleza, Cear\u00e1 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8978-9903","authenticated-orcid":false,"suffix":"MD","given":"Lu\u00eds Arthur Brasil Gadelha","family":"Farias","sequence":"additional","affiliation":[{"name":"Universidade Federal do Cear\u00e1, Faculdade de Medicina, Departamento de Sa\u00fade Comunit\u00e1ria , Postal code 60441-750, Fortaleza, Cear\u00e1 , Brazil"},{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas , Postal code 60455-610, Fortaleza, Cear\u00e1 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"M.Sc","given":"Guilherme Alves de Lima","family":"Henn","sequence":"additional","affiliation":[{"name":"Hospital S\u00e3o Jos\u00e9 de Doen\u00e7as Infecciosas , Postal code 60455-610, Fortaleza, Cear\u00e1 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"PhD","given":"Rosa Salani","family":"Mota","sequence":"additional","affiliation":[{"name":"Universidade Federal do Cear\u00e1, Faculdade de Medicina, Departamento de Sa\u00fade Comunit\u00e1ria , Postal code 60441-750, Fortaleza, Cear\u00e1 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"MD","given":"Rafael de Sousa","family":"Costa","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o de Ci\u00eancia e Pesquisa Maria Ione Xerez Vasconcelos \u2013 FUNCIPE , Postal code 60040-430, Fortaleza, Cear\u00e1 , Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"PhD","given":"Lisandra Serra","family":"Damasceno","sequence":"additional","affiliation":[{"name":"Universidade Federal do Cear\u00e1, Faculdade de Medicina, Departamento de Sa\u00fade Comunit\u00e1ria , Postal code 60441-750, Fortaleza, Cear\u00e1 , Brazil"},{"name":"Hospital S\u00e3o 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