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Prevalence of histoplasmin sensitivity in healthy adults and tuberculosis patients in southwest China.

Two hundred and seventy-one healthy students and workers and 28 hospitalized tuberculosis patients living in Sichuan Province (southwest People's Republic of China; PRC) were tested with histolyn and tuberculin. The age of the tested subjects ranged from 17 to 22 years among the students, 17 to 38, among the workers and 17 to their 70s among the patients. Thirty-eight students (24%), 21 workers (18%) and 8 patients (29%) reacted positively to histolyn, none of the differences being statistically significant. Positive reactions were significantly more frequent among students from the south of Sichuan Province (35%) than from the north (6%). The rates of positive reaction to tuberculin in the students (25%) and in the workers (27%) indicates that tuberculous infection continues to be a significant problem in southwestern PRC. The significant rate of histolyn reaction among the tuberculosis patients raises the possibility of either infection with both Histoplasma capsulatum and Mycobacterium tuberculosis, or a missed diagnosis of chronic pulmonary histoplasmosis.

Adolescent↗
PubMedDate not supplied

Risk factors for choroidal neovascularization in young patients: a case-control study.

A pair-matched, case-control design was used to study exposure to Histoplasma capsulatum and other environmental factors, and to determine various host characteristics including human leukocyte antigen (HLA) typings in 94 young patients with macular choroidal neovascularization (CNV) and in 94 controls with other eye diseases. Patients with two types of retinal patterns were studied: Type I, or those with CNV with one or no chorioretinal atrophic spots in the posterior pole or periphery (n = 51), and Type II, or those with CNV and 2 or more chorioretinal atrophic spots (n = 43). Our purpose was to explore whether these two variants of idiopathic CNV have different and distinguishable epidemiologies which may or may not be related to prior exposure to Histoplasma. We found that histoplasmin skin tests were negative in all but two Type I cases. The combination of the HLA-B7 and HLA-DR2 markers (but not either marker alone) was significantly increased in Type I cases. Among Type II cases, HLA-B7, HLA-DR2, HLA-DQ1, a positive histoplasmin skin test, myopic refractive error, prior residence in a histoplasmosis endemic area, occupations involving exposure to animals, and hypertension were all significantly increased. Histoplasmin skin test responses were positive in 18 Type II cases (45%). In the multivariate analysis, only DR2 and the combined presence of DQ1 and a positive histoplasmin skin test remained predictive of Type II disease. Our findings suggest that histoplasmin sensitivity is associated with some, but not all, cases of Type II disease. However, histoplasmin sensitivity appears to have no relationship to Type I disease. HLA factors may play a role in both disease types, possibly by producing a modified immune response to Histoplasma and/or other unidentified agents.

Adolescent↗