Furthermore, the
histoplasmin skin test is no longer available, and another approach is needed.
Presumed ocular histoplasmosis syndrome (POHS) was first described in 1959 by Woods and Wahlen (1) as peripheral chorioretinal scar and hemorrhagic macular disciform lesion in a patient with positive
histoplasmin skin test.
Couch, "Pericardial calcification and
histoplasmin sensitivity," Annals of Internal Medicine, vol.
The
histoplasmin skin test is usually not helpful in diagnosis, as it does not provide evidence of the presence of the disease.
Historically,
histoplasmin reactivity in a representative Kankakee County population has been 20-39% versus 60-69% in populations in central Illinois (Edwards et al.
Agents evaluated include antigens for Candida, mumps,
histoplasmin, tetanus, and Trichophyton.
Skin sensitivity to
histoplasmin in Calcutta and its neighbourhood IJDVL 1980; 46:94-8.
The diagnosis can also be made by serology, biopsy, enzyme immunoassay test and intradermal reaction to
histoplasmin. (1)
Delayed hypersensitivity response of experimental animals to
histoplasmin from the yeast and mycelial phases of Histoplasma capsulatum.
Epidemiologic skin test survey of sensitivity to paracoccidiodin,
histoplasmin and sporotrichin among gold mine workers of Morro Velho Mining, Brazil.
This condition occurs in many different areas of the world, but the largest endemic focus is in the southeastern and midwestern United States, where up to 80% to 90% of the population may exhibit a positive intradermal
histoplasmin skin test.[1] Acute disseminated histoplasmosis, quite rare before the acquired immunodeficiency syndrome (AIDS) epidemic, is now much more common, occurring in 2.7% to 5% of AIDS patients in nonendemic areas and in up to 27% of AIDS patients in endemic areas of the United States.[2-4] Acute disseminated histoplasmosis often occurs early in the course of HIV infection and is the AIDS-defining illness in at least half of these cases.[5]
Edwards LB, Acquaviva FA, Livesay VT, et al: An atlas of sensitivity to tuberculin, PPD-B, and
histoplasmin in the United States.