|Year : 2007 | Volume
| Issue : 4 | Page : 428
Department of Microbiology, BJ Medical College, Pune - 411 001, Maharashtra, India
R S Bharadwaj
Department of Microbiology, BJ Medical College, Pune - 411 001, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Bharadwaj R S. Authors' reply. Indian J Med Microbiol 2007;25:428
The case report of disseminated histoplasmosis in a patient with AIDS was published with the idea of increasing awareness of this condition and we are happy with the response we have received. Acute disseminated histoplasmosis is considered an AIDS indicator disease and yet reports from this country are very few. This is in spite of the fact that India is one of the major foci of the AIDS pandemic. One of the reasons for this as aptly brought out by Goswami et al.  is that Histoplasma culture is difficult unless the appropriate sample is collected and there is a high index of suspicion by the microbiologist. Though the disease is more commonly reported from the Eastern parts of India, it is by no means restricted to these parts of the country as amply demonstrated by the article by Subramaniam et al.  and an earlier review by Randhawa et al.  Increased travel within the country has made the prevalence of the disease more widespread than it was previously believed to be and is at present still under-reported.
Though our culture showed abundant microconidia, the picture published with the article attempted to demonstrate the macroconidia as these are more characteristic of the organism. The photograph also shows many macroconidia without the characteristic tubercles and one in which these tubercles are just appearing. This has been aptly brought out in the comments by Goswami et al. ,  who have described that typical macroconidia may sometime appear late and most of these may be initially without tuberculated processes. An arrow was placed in the photograph pointing to the yeast phase of the organism.
By the time this article was submitted for publication, the series of Subramaniam et al.  mentioned above had not been published. However, in spite of an extensive review of available literature, we missed the single culture positive case in the study by Goswami et al.  Therefore, the credit for the first culture of Histoplasma from a patient with disseminated histoplasmosis in an AIDS patient must go to them.
| ~ References|| |
|1.||Goswami RP, Pramanik N, Banerjee D, Reza MM, Guha SK, Maiti PK. Histoplasmosis in eastern India: The tip of the iceberg? Tran R Soc Trop Med Hyg 1999; 93 :540-2. |
|2.||Subramanian S, Abraham OC, Rupali P, Zachariah A, Mathews MS, Mathai D. Disseminated histoplasmosis. J Assoc Physicians India 2005; 53 :185-9. |
|3.||Randhawa HS, Khan ZU. Histoplasmosis in India: Current status. Indian J Chest Dis Allied Sci 1994; 36 :193-21. [PUBMED] |