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{"title"=>"Histoplasmosis or Tuberculosis in HIV-Infected Patients in the Amazon: What Should Be Treated First?", "type"=>"journal", "authors"=>[{"first_name"=>"Mathieu", "last_name"=>"Nacher", "scopus_author_id"=>"7006076854"}, {"first_name"=>"Antoine", "last_name"=>"Adenis", "scopus_author_id"=>"57108772300"}, {"first_name"=>"Emilie", "last_name"=>"Sambourg", "scopus_author_id"=>"55861540400"}, {"first_name"=>"Florence", "last_name"=>"Huber", "scopus_author_id"=>"23008576200"}, {"first_name"=>"Philippe", "last_name"=>"Abboud", "scopus_author_id"=>"7004337548"}, {"first_name"=>"Loïc", "last_name"=>"Epelboin", "scopus_author_id"=>"6503960790"}, {"first_name"=>"Emilie", "last_name"=>"Mosnier", "scopus_author_id"=>"24344432000"}, {"first_name"=>"Vincent", "last_name"=>"Vantilcke", "scopus_author_id"=>"23010319400"}, {"first_name"=>"Julie", "last_name"=>"Dufour", "scopus_author_id"=>"13406415100"}, {"first_name"=>"Félix", "last_name"=>"Djossou", "scopus_author_id"=>"55894452300"}, {"first_name"=>"Magalie", "last_name"=>"Demar", "scopus_author_id"=>"6602719049"}, {"first_name"=>"Pierre", "last_name"=>"Couppié", "scopus_author_id"=>"7006805452"}], "year"=>2014, "source"=>"PLoS Neglected Tropical Diseases", "identifiers"=>{"pui"=>"603940713", "doi"=>"10.1371/journal.pntd.0003290", "pmid"=>"20153021185", "issn"=>"19352735", "scopus"=>"2-s2.0-84928254307", "sgr"=>"84928254307"}, "id"=>"71aa9f35-0f9c-3aad-9808-9fac9999dacc", "abstract"=>"Using longitudinal data from the French Hospital Database on HIV infection in French Guiana between 1996-2008, this article compares the incidence and mortality rates of histoplasmosis and tuberculosis in human immunodeficiency virus (HIV)-infected patients. In an Amazonian context, among immunosuppressed patients, the incidence of histoplasmosis was higher than that of tuberculosis. Despite comparable overall mortality in terms of proportion of patients with histoplasmosis and tuberculosis dying, the number of histoplasmosis-related deaths was higher. Thus, for HIV patients with CD4 counts below 200 with a tuberculosis-like syndrome (histoplasmosis-like may be a more appropriate heuristic in our epidemiological context), clinicians with poor diagnostic facilities may be better inspired, given the differences in incidence rates, to start with amphotericin B (ideally in its liposomal formulation) than antituberculosis drugs and reevaluate the situation 3-7 days later in view of the treatment response.", "link"=>"http://www.mendeley.com/research/histoplasmosis-tuberculosis-hivinfected-patients-amazon-treated-first", "reader_count"=>13, "reader_count_by_academic_status"=>{"Unspecified"=>2, "Researcher"=>3, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>3, "Other"=>1, "Student > Bachelor"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>2, "Researcher"=>3, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>3, "Other"=>1, "Student > Bachelor"=>2, "Lecturer > Senior Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>2, "Environmental Science"=>1, "Nursing and Health Professions"=>1, "Agricultural and Biological Sciences"=>2, "Medicine and Dentistry"=>5, "Business, Management and Accounting"=>1, "Immunology and Microbiology"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>5}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Unspecified"=>{"Unspecified"=>2}, "Environmental Science"=>{"Environmental Science"=>1}}, "reader_count_by_country"=>{"Brazil"=>1, "United Kingdom"=>1}, "group_count"=>2}

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• http://doi.org/10.1016/j.tim.2017.02.013
• http://doi.org/10.1016/S1473-3099(18)30354-2
• http://doi.org/10.1371/journal.pntd.0009215
• http://doi.org/10.1371/journal.pntd.0007692
• http://doi.org/10.1590/0037-8682-0425-2017
• http://doi.org/10.4269/ajtmh.15-0837
• http://doi.org/10.1097/QAD.0000000000000961
• http://doi.org/10.1186/s12879-018-3499-5
• http://doi.org/10.3390/jof5020047
• http://doi.org/10.1098/rstb.2015.0468
• http://doi.org/10.3390/jof6040319
• http://doi.org/10.1111/myc.13023
• http://doi.org/10.1128/JCM.01959-17

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• {"type"=>"COMMENT", "annotationUri"=>"info:doi/10.1371/annotation/53c0542a-d382-4678-866e-f13d2d55ffb1", "title"=>"Interesting report that underscores an unmet medical need", "body"=>"This is an interesting report highlighting a dilemma that physicians in endemic regions often face. Histoplasmosis and tuberculosis, both chronic granulomatous disorders, often present with similar clinical as well as histopathological manifestations, which are difficult to set apart. (Side note: I am amused that the authors have used a 1948 reference in support of this fact. However, for those interested, Mukhopadhyay and Gal have a detailed treatise describing these features in \"Arch Pathol Lab Med\", 134:667-690, May 2010.) Both have significant morbidity and mortality associated with them. Therefore, which one to treat first in HIV patients becomes a crucial patient management question. \n\nThe authors have pointed out that the respective infections have been diagnosed based on established guidelines. However, this report - to me - seems to highlight yet again the crying need for early, accurate, and reasonably non-invasive Histoplasma diagnostics to be employed in both diagnostic and surveillance capacities in appropriate regions.", "isRemoved"=>false, "created"=>"2014-12-08T22:47:03Z", "lastModified"=>"2014-12-08T22:47:03Z", "creator"=>{"userId"=>"403"}, "highlightedText"=>"", "competingInterestStatement"=>{"creatorWasPrompted"=>true, "hasCompetingInterests"=>true, "body"=>"I work in fungal diagnostics, and would love to reach these supplemental healthcare options to those parts of the world where they are needed most."}, "parentArticle"=>{"doi"=>"info:doi/10.1371/journal.pntd.0003290", "state"=>"published", "journals"=>{"PLoSNTD"=>{"journalKey"=>"PLoSNTD", "eIssn"=>"1935-2735", "title"=>"PLOS Neglected Tropical Diseases"}}}, "replyTreeSize"=>0, "mostRecentActivity"=>"2014-12-08T22:47:03Z", "replies"=>[]}

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• {"id"=>"546132560796196865", "text"=>"treating histoplasmosis versus tuberculosis in HIV-infected patients http://t.co/G36tIagiAq @PLOSNTDs", "created_at"=>"2014-12-20T02:38:43Z", "user"=>"danjbecker", "user_name"=>"Dan Becker", "user_profile_image"=>"http://pbs.twimg.com/profile_images/519327965633454080/iDxlLUAG_normal.jpeg"}

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Relative Metric

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F1000Prime