An Outbreak of Histoplasmosis among Healthy Young Japanese Women after Traveling to Southeast Asia

Hideaki Ohno; Yoshiko Ogata; Hajime Suguro; Soichiro Yokota; Akira Watanabe; Katsuhiko Kamei; Satoshi Yamagoe; Akiko Ishida-Okawara; Yukihiro Kaneko; Atsuko Horino; Kunikazu Yamane; Takahiro Tsuji; Noriyo Nagata; Hideki Hasegawa; Yoshichika Arakawa; Tetsutaro Sata; Yoshitsugu Miyazaki

doi:10.2169/internalmedicine.49.2759

CASE REPORTS

An Outbreak of Histoplasmosis among Healthy Young Japanese Women after Traveling to Southeast Asia

Hideaki Ohno, Yoshiko Ogata, Hajime Suguro, Soichiro Yokota, Akira Watanabe, Katsuhiko Kamei, Satoshi Yamagoe, Akiko Ishida-Okawara, Yukihiro Kaneko, Atsuko Horino, Kunikazu Yamane, Takahiro Tsuji, Noriyo Nagata, Hideki Hasegawa, Yoshichika Arakawa, Tetsutaro Sata, Yoshitsugu Miyazaki

Author information

Hideaki Ohno
Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases
Yoshiko Ogata
National Hospital Organization, Yamaguchi-Ube Medical Center
Hajime Suguro
Department of Respiratory Medicine, Yokohama Social Insurance Chuo Hospital
Soichiro Yokota
Division of Respiratory Disease, National Hospital Organization Toneyama National Hospital
Akira Watanabe
Division of Fungal Infection, Medical Mycology Research Center, Chiba University
Katsuhiko Kamei
Division of Fungal Infection, Medical Mycology Research Center, Chiba University
Satoshi Yamagoe
Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases
Akiko Ishida-Okawara
Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases
Yukihiro Kaneko
Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases
Atsuko Horino
Department of Bacteriology II, National Institute of Infectious Diseases
Kunikazu Yamane
Department of Bacteriology II, National Institute of Infectious Diseases
Takahiro Tsuji
Department of Pathology, National Institute of Infectious Diseases
Noriyo Nagata
Department of Pathology, National Institute of Infectious Diseases
Hideki Hasegawa
Department of Pathology, National Institute of Infectious Diseases
Yoshichika Arakawa
Department of Bacteriology II, National Institute of Infectious Diseases
Tetsutaro Sata
Department of Pathology, National Institute of Infectious Diseases
Yoshitsugu Miyazaki
Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases

Keywords: histoplasmosis, outbreak, serological test, PCR

JOURNAL OPEN ACCESS

2010 Volume 49 Issue 5 Pages 491-495

DOI https://doi.org/10.2169/internalmedicine.49.2759

Details

Abstract

Histoplasmosis, caused by Histoplasma capsulatum, is an endemic mycosis in many countries of the world except for Japan. Outbreaks of histoplasmosis among Japanese people are very rare and are mainly imported by travelers. We report an outbreak of histoplasmosis among healthy Japanese people who traveled to a resort area in Southeast Asia. Three young Japanese women traveled to Langkawi island, Malaysia and stayed on the island for five days without visiting caves, a known reservoir of H. capsulatum. All three individuals developed flu-like symptoms with multiple nodule shadows on chest X rays or chest CT scans at around ten days after their return to Japan. Serum samples obtained from the three subjects were positive for anti-Histoplasma antibody and specific PCR for H. capsulatum on lung biopsy specimens and the serum from one patient was positive. The clinical course of all three patients improved without the use of anti-fungal agents and no recurrence has been confirmed. Clinical attendants should consider histoplasmosis when they see patients with flu-like symptoms with abnormal chest X-rays after visiting H. capsulatum endemic areas, especially Southeast Asia.

Corresponding author

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