ABSTRACT
A 55-year-old woman presented 18 months after a trip to Ecuador with night sweat, malaise, and an unclear lesion of the lung. Computed tomography of the lung showed a nodular lesion of 14 mm. Antibodies against Histoplasma capsulatum were detected in the complement fixation text (CFT) and IgG western blot. Re-examination of a formalin fixed paraffin embedded (FFPE) lung-biopsy revealed yeasts after silver staining, compatible with H. capsulatum , which was verified by extraction and amplification of DNA from FFPE. After therapy with itraconazole 400 mg/day, the patient showed an uneventful clinical recovery without regression of the lung lesion. The serological follow-up examination after 17 months showed CFT without pathological findings.
Subject(s)
Arthritis/prevention & control , Exanthema/prevention & control , Fever of Unknown Origin/prevention & control , Histoplasmosis/diagnosis , Histoplasmosis/drug therapy , Travel , Antifungal Agents/therapeutic use , Arthritis/diagnosis , Arthritis/immunology , Complement Fixation Tests , Cough/diagnosis , Cough/immunology , Cough/prevention & control , Ecuador , Exanthema/diagnosis , Exanthema/immunology , Female , Fever of Unknown Origin/diagnosis , Fever of Unknown Origin/immunology , Histoplasmosis/immunology , Humans , Itraconazole/therapeutic use , Middle AgedABSTRACT
We report on malaria acquired by German tourists to formerly non-endemic tourist resorts in the Dominican Republic between July 1999 and March 2000. Falciparum malaria is endemic in the western provinces and the hinterland of the Dominican Republic. By contrast, the risk of contracting malaria has always been considered so low in the main tourist resorts in the eastern part of the country that antimalarial chemoprophylaxis was not recommended.