Histoplasmosis occurs in 5-10% of HIV-infected patients in endemic areas and evolves to severe and disseminated infection with mortality rates over 50% in some regions. This report presents epidemiological, clinical and outcome data from HIV-infected patients with histoplasmosis confirmed by culture and/or at necropsy who were admitted to a Brazilian teaching hospital. Data from 65 patients were obtained from their respective medical and necropsy records. From 2005 to 2018, 36 HIV-infected patients were diagnosed with histoplasmosis confirmed by culture. At admission, most of these patients presented disseminated fungal infection, whereas 15 (41.7%) were simultaneously diagnosed with both HIV infection and histoplasmosis. Fever, weight loss, hepatosplenomegaly, respiratory and digestive symptoms were present in 86.2%, 50%, 44.4% and 41.7% of the patients, respectively. At admission, 24 patients had low CD4 T-cell count and high viral load values. Among the 30 patients who received antifungals, 16 (53.3%) were cured, 13 (43.3%) died, and one was lost to follow-up. Six patients died prior to therapy. From 1990 to 2018, 63 necropsies of patients with Histoplasma capsulatum infection were performed. Of these patients, 29 (46.0%) were HIV-infected individuals, including 21 (72.4%) who presented disseminated histoplasmosis and 21 (72.4%) who were diagnosed with histoplasmosis at necropsy. The epidemiological, clinical and outcome profiles presented herein are similar to those described elsewhere and reinforce the difficulties that are still present in limited-resource settings where advanced immunodeficiency, combined with severe fungal infection and late patient admissions, is related to poor outcomes.

中文翻译：

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HIV感染患者的组织胞浆菌病：来自巴西教学医院的流行病学，临床和尸检数据。

组织胞浆菌病发生在流行地区的5-10％的HIV感染患者中，并发展成严重的和分散的感染，在某些地区死亡率超过50％。该报告提供了通过文化和/或尸检证实并被巴西教学医院收治的，感染了艾滋病毒的组织胞浆菌病患者的流行病学，临床和结局数据。来自65名患者的数据来自各自的医疗和尸检记录。从2005年到2018年，通过培养确定了36例HIV感染患者被诊断出组织胞浆菌病。入院时，大多数患者出现了散布性真菌感染，而同时被诊断出同时感染了HIV和组织胞浆菌病的有15名（41.7％）。发烧，体重减轻，肝脾肿大，呼吸和消化系统症状分别占86.2％，50％，44.4％和41。分别有7％的患者。入院时，有24名患者CD4 T细胞计数低和病毒载量高。在接受抗真菌剂治疗的30例患者中，有16例（53.3％）治愈了，13例（43.3％）死亡，其中一名失访。有六名患者在治疗前死亡。从1990年到2018年，共进行了63例包膜组织胞浆菌感染患者的尸检。在这些患者中，有29名（46.0％）为HIV感染者，其中包括21例（72.4％）呈弥漫性组织胞浆菌病，以及21例（72.4％）在尸检时被诊断为组织胞浆菌病。本文介绍的流行病学，临床和预后状况与其他地方所描述的相似，并加剧了在资源有限的地区仍然存在的困难，在这些地区，晚期免疫缺陷，严重的真菌感染和晚期患者入院，