{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T19:13:47Z","timestamp":1790709227196,"version":"4.1.0"},"reference-count":60,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T00:00:00Z","timestamp":1576195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Histoplasmosis is a common but neglected AIDS-defining condition in endemic areas for Histoplasma capsulatum. At the advanced stage of HIV infection, the broad spectrum of clinical features may mimic other frequent opportunistic infections such as tuberculosis and makes it difficult for clinicians to diagnose histoplasmosis in a timely manner. Diagnosis of histoplasmosis is difficult and relies on a high index of clinical suspicion along with access to medical mycology facilities with the capacity to implement conventional diagnostic methods (direct examination and culture) in a biosafety level 3 laboratory as well as indirect diagnostic methods (molecular biology, antibody, and antigen detection tools in tissue and body fluids). Time to initiation of effective antifungals has an impact on the patient\u2019s prognosis. The initiation of empirical antifungal treatment should be considered in endemic areas for Histoplasma capsulatum and HIV. Here, we report on 30 years of experience in managing HIV-associated histoplasmosis based on a synthesis of clinical findings in French Guiana with considerations regarding the difficulties in determining its differential diagnosis with other opportunistic infections.<\/jats:p>","DOI":"10.3390\/jof5040115","type":"journal-article","created":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T11:27:22Z","timestamp":1576236442000},"page":"115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["The Broad Clinical Spectrum of Disseminated Histoplasmosis in HIV-Infected Patients: A 30 Years\u2019 Experience in French Guiana"],"prefix":"10.3390","volume":"5","author":[{"given":"Pierre","family":"Couppi\u00e9","sequence":"first","affiliation":[{"name":"Service de Dermatologie-V\u00e9n\u00e9rologie, Centre Hospitalier de Cayenne, Avenue des Flamboyants, BP 6006, 97300 Cayenne, France"},{"name":"Equipe EA3593, Ecosyst\u00e8mes Amazoniens et Pathologie Tropicale, Universit\u00e9 de Guyane, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Herceg","sequence":"additional","affiliation":[{"name":"Equipe EA3593, Ecosyst\u00e8mes Amazoniens et Pathologie Tropicale, Universit\u00e9 de Guyane, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgane","family":"Bourne-Watrin","sequence":"additional","affiliation":[{"name":"Service de Dermatologie-V\u00e9n\u00e9rologie, Centre Hospitalier de Cayenne, Avenue des Flamboyants, BP 6006, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Thomas","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine B, Centre Hospitalier de Cayenne, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Blanchet","sequence":"additional","affiliation":[{"name":"Equipe EA3593, Ecosyst\u00e8mes Amazoniens et Pathologie Tropicale, Universit\u00e9 de Guyane, 97300 Cayenne, France"},{"name":"Laboratoire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5975-2627","authenticated-orcid":false,"given":"Kinan Drak","family":"Alsibai","sequence":"additional","affiliation":[{"name":"Laboratoire d\u2019Anatomie et Cytologie Pathologique, Centre Hospitalier de Cayenne, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Louvel","sequence":"additional","affiliation":[{"name":"Service de M\u00e9decine B, Centre Hospitalier de Cayenne, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Djossou","sequence":"additional","affiliation":[{"name":"Equipe EA3593, Ecosyst\u00e8mes Amazoniens et Pathologie Tropicale, Universit\u00e9 de Guyane, 97300 Cayenne, France"},{"name":"Unit\u00e9 de Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3414-0821","authenticated-orcid":false,"given":"Magalie","family":"Demar","sequence":"additional","affiliation":[{"name":"Equipe EA3593, Ecosyst\u00e8mes Amazoniens et Pathologie Tropicale, Universit\u00e9 de Guyane, 97300 Cayenne, France"},{"name":"Laboratoire de Parasitologie-Mycologie, Centre Hospitalier de Cayenne, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3695-6824","authenticated-orcid":false,"given":"Romain","family":"Blaizot","sequence":"additional","affiliation":[{"name":"Service de Dermatologie-V\u00e9n\u00e9rologie, Centre Hospitalier de Cayenne, Avenue des Flamboyants, BP 6006, 97300 Cayenne, France"},{"name":"Equipe EA3593, Ecosyst\u00e8mes Amazoniens et Pathologie Tropicale, Universit\u00e9 de Guyane, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4000-4981","authenticated-orcid":false,"given":"Antoine","family":"Adenis","sequence":"additional","affiliation":[{"name":"Equipe EA3593, Ecosyst\u00e8mes Amazoniens et Pathologie Tropicale, Universit\u00e9 de Guyane, 97300 Cayenne, France"},{"name":"Centre d\u2019Investigation Clinique Antilles Guyane, Inserm CIC 1424, Centre Hospitalier de Cayenne, 97300 Cayenne, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,12,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1016\/S1473-3099(17)30303-1","article-title":"Fungal infections in HIV\/AIDS","volume":"17","author":"Limper","year":"2017","journal-title":"Lancet Infect. 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