All but one were immigrants Ruxolitinib in vivo with AIDS as underlying condition (97%). One patient was an oncohematological patient (Table 2, patient 11) and was classified as a possible case. The other 29 cases were classified as proven (97%). The culture was positive in 73% of patients (22 cases) but always several weeks after the onset of symptoms. In seven cases (23%) the fungi was not cultured and the yeast cells were visualized in the tissues. The immunodiffusion test was performed in sera from 20 patients and was positive in only eight patients (40%). RT-PCR was performed in samples from

27 patients and was positive in 24 patients, showing a sensitivity of 89%. By samples, RT-PCR was performed on 54 samples from these patients: 16 sera, 10 respiratory samples, 8 blood samples,

6 biopsies, 6 bone marrow BMS-734016 samples, 4 plasma samples, 3 lymph node biopsies, and 1 cerebrospinal fluid. The RT-PCR was positive in 11 sera (69%), 10 respiratory samples (100%), 3 blood samples (37.5%), 6 biopsies (100%), 4 bone marrow samples (67%), three plasma samples (75%), and two lymph nodes (67%). Results were obtained within 24 hours of receiving the samples. When the fungus had been cultured, DNA was extracted from mycelia to perform PCR amplification and sequencing of ITS regions. All sequences matched with H capsulatum. We obtained the variety duboisii in three patients from African countries (Table 2; patients 7, 29, and 30). We had six patients with proven PCM. The fungus was cultured only in one patient several weeks after receiving the sample (CNM-CM5413). In the other cases characteristic budding yeasts were observed in clinical samples. The immunodiffusion test was performed in sera from five patients

and was positive in all cases (100%), although the signal was very weak in three of them (60%). RT-PCR was performed on samples from these six patients and was positive in all cases (100%). By samples, RT-PCR was performed on four tissue biopsies, four serum samples, three blood samples, two sputum samples, one bronchoalveolar lavage (BAL), and one lung biopsy. RT-PCR was positive in two blood samples (66%), two sputum samples (100%), four biopsies (100%), one BAL (100%), and one lung biopsy Methisazone (100%). The RT-PCR results were also obtained 24 hours after receiving the samples. DNA was extracted from the isolated strain (CNM-CM5413) to perform a PCR amplification of the ITS region, followed by sequencing. The sequence matched with P brasiliensis. In two patients, we tested samples several weeks after starting the antifungal therapy, showing that the amount of DNA had either decreased or disappeared.25 Diagnosis of histoplasmosis and PCM is very frequently hampered by a lack of experience in non-endemic areas.