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Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana

Disseminated histoplasmosis is a major cause of mortality in HIV-infected patients. Rapid and efficient diagnosis of Histoplasma capsulatum is crucial. Cytopathology is available in most hospitals and represents a rapid diagnostic alternative. In this study, we reviewed 12 years of experience to des...

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Autores principales: Drak Alsibai, Kinan, Aissaoui, Houari, Adenis, Antoine, Bourne-Watrin, Morgane, Djossou, Felix, Epelboin, Loïc, Blanchet, Denis, Demar, Magalie, Couppié, Pierre, Nacher, Mathieu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304076/
https://www.ncbi.nlm.nih.gov/pubmed/34356955
http://dx.doi.org/10.3390/jof7070576
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author Drak Alsibai, Kinan
Aissaoui, Houari
Adenis, Antoine
Bourne-Watrin, Morgane
Djossou, Felix
Epelboin, Loïc
Blanchet, Denis
Demar, Magalie
Couppié, Pierre
Nacher, Mathieu
author_facet Drak Alsibai, Kinan
Aissaoui, Houari
Adenis, Antoine
Bourne-Watrin, Morgane
Djossou, Felix
Epelboin, Loïc
Blanchet, Denis
Demar, Magalie
Couppié, Pierre
Nacher, Mathieu
author_sort Drak Alsibai, Kinan
collection PubMed
description Disseminated histoplasmosis is a major cause of mortality in HIV-infected patients. Rapid and efficient diagnosis of Histoplasma capsulatum is crucial. Cytopathology is available in most hospitals and represents a rapid diagnostic alternative. In this study, we reviewed 12 years of experience to describe the cytology of histoplasmosis diagnosed by bronchoalveolar lavage (BAL) in relation to patient characteristics. BAL-diagnosed pulmonary histoplasmosis concerned 17 patients (14 HIV+). BAL cellularity ranged from 76,000 to 125,000 cells/mL in HIV patients, and 117,000 to 160,000 cells/mL in non-HIV patients. Macrophages predominated in all HIV patients (from 60% to 88%), lymphocytic infiltrates ranged from 5% to 15%, and neutrophils were very heterogeneous (from 2% to 32%). The number of H. capsulatum at hot spots seemed greater in HIV-infected than in immunocompetent patients (9 to 375 vs. 4 to 10) and were inversely proportional to the CD4 counts. Yeasts were both intracellular and extracellular in 85.7% of the HIV patients. This is the most comprehensive series detailing the cytological aspects of BAL in the diagnosis of H. capsulatum, focusing on the number of yeasts and their clustering pattern. The cytological examination of the Gomori-Grocott-stained BAL allows a reliable diagnosis of histoplasmosis.
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spelling pubmed-83040762021-07-25 Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana Drak Alsibai, Kinan Aissaoui, Houari Adenis, Antoine Bourne-Watrin, Morgane Djossou, Felix Epelboin, Loïc Blanchet, Denis Demar, Magalie Couppié, Pierre Nacher, Mathieu J Fungi (Basel) Article Disseminated histoplasmosis is a major cause of mortality in HIV-infected patients. Rapid and efficient diagnosis of Histoplasma capsulatum is crucial. Cytopathology is available in most hospitals and represents a rapid diagnostic alternative. In this study, we reviewed 12 years of experience to describe the cytology of histoplasmosis diagnosed by bronchoalveolar lavage (BAL) in relation to patient characteristics. BAL-diagnosed pulmonary histoplasmosis concerned 17 patients (14 HIV+). BAL cellularity ranged from 76,000 to 125,000 cells/mL in HIV patients, and 117,000 to 160,000 cells/mL in non-HIV patients. Macrophages predominated in all HIV patients (from 60% to 88%), lymphocytic infiltrates ranged from 5% to 15%, and neutrophils were very heterogeneous (from 2% to 32%). The number of H. capsulatum at hot spots seemed greater in HIV-infected than in immunocompetent patients (9 to 375 vs. 4 to 10) and were inversely proportional to the CD4 counts. Yeasts were both intracellular and extracellular in 85.7% of the HIV patients. This is the most comprehensive series detailing the cytological aspects of BAL in the diagnosis of H. capsulatum, focusing on the number of yeasts and their clustering pattern. The cytological examination of the Gomori-Grocott-stained BAL allows a reliable diagnosis of histoplasmosis. MDPI 2021-07-19 /pmc/articles/PMC8304076/ /pubmed/34356955 http://dx.doi.org/10.3390/jof7070576 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Drak Alsibai, Kinan
Aissaoui, Houari
Adenis, Antoine
Bourne-Watrin, Morgane
Djossou, Felix
Epelboin, Loïc
Blanchet, Denis
Demar, Magalie
Couppié, Pierre
Nacher, Mathieu
Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana
title Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana
title_full Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana
title_fullStr Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana
title_full_unstemmed Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana
title_short Cytological Spectrum of Pulmonary Histoplasmosis Diagnosed by Bronchoalveolar Lavage: 12 Years of Experience in French Guiana
title_sort cytological spectrum of pulmonary histoplasmosis diagnosed by bronchoalveolar lavage: 12 years of experience in french guiana
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304076/
https://www.ncbi.nlm.nih.gov/pubmed/34356955
http://dx.doi.org/10.3390/jof7070576
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