<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0375-0760</journal-id>
<journal-title><![CDATA[Revista Cubana de Medicina Tropical]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Cubana Med Trop]]></abbrev-journal-title>
<issn>0375-0760</issn>
<publisher>
<publisher-name><![CDATA[Centro Nacional de Información de Ciencias Médicas]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0375-07602023000100002</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Brote de histoplasmosis en el contexto de la pandemia por COVID-19]]></article-title>
<article-title xml:lang="en"><![CDATA[Histoplasmosis outbreak in the context of the COVID-19 pandemic]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Abreu La Rosa]]></surname>
<given-names><![CDATA[Idioel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García Gómez]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fragoso Marchante]]></surname>
<given-names><![CDATA[María Caridad]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cruz de los Santos]]></surname>
<given-names><![CDATA[Héctor Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cuéllar Oramas]]></surname>
<given-names><![CDATA[Yanisleydi]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Provincial Gustavo Aldereguía Lima (GAL)  ]]></institution>
<addr-line><![CDATA[ Cienfuegos]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2023</year>
</pub-date>
<volume>75</volume>
<numero>1</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S0375-07602023000100002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S0375-07602023000100002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S0375-07602023000100002&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La histoplasmosis es una micosis profunda de distribución mundial causada por el Histoplasma capsulatum var. capsulatum. Se caracteriza por una variabilidad clínica que depende principalmente de la carga fúngica, del estado inmunológico del paciente y de la virulencia del germen. Se describe un brote de histoplasmosis pulmonar aguda en militares, producido en el contexto epidemiológico de la COVID-19. El episodio tuvo lugar a partir de actividad laboral en cuevas donde participaron cuatro militares, tres de los cuales desarrollaron síntomas y fueron admitidos en el Hospital Dr. Gustavo Aldereguía Lima de Cienfuegos en enero de 2022. La información fue obtenida a través de la entrevista médica y la historia clínica. Se evidenció que en el contexto epidemiológico de la pandemia por COVID-19 no se debe subestimar el diagnóstico de otras enfermedades respiratorias, incluidas las micosis endémicas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Histoplasmosis is a deep mycotic infection of worldwide distribution caused by Histoplasma capsulatum var. capsulatum. It is characterized by clinical variability that depends mainly on the fungal load, the patient's immune status and the virulence of the germ. We describe an outbreak of acute pulmonary histoplasmosis among military officers, which occurred in the epidemiological context of COVID-19. The episode occurred during work activities in caves in which four soldiers participated, three of whom developed symptoms and were admitted to the "Dr. Gustavo Aldereguía Lima" Hospital in Cienfuegos in January 2022. The information was obtained through medical interviews and clinical records. It was evidenced that in the epidemiological context of the COVID-19 pandemic, the diagnosis of other respiratory diseases, including endemic mycoses, should not be underestimated.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Histoplasma capsulatum var. capsulatum]]></kwd>
<kwd lng="es"><![CDATA[histoplasmosis]]></kwd>
<kwd lng="es"><![CDATA[brote epidémico]]></kwd>
<kwd lng="es"><![CDATA[coronavirus]]></kwd>
<kwd lng="en"><![CDATA[Histoplasma capsulatum var. capsulatum]]></kwd>
<kwd lng="en"><![CDATA[histoplasmosis]]></kwd>
<kwd lng="en"><![CDATA[epidemic outbreak]]></kwd>
<kwd lng="en"><![CDATA[coronavirus]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marulanda Nieto]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Gartner López]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz Gómez]]></surname>
<given-names><![CDATA[CJ]]></given-names>
</name>
<name>
<surname><![CDATA[Aguilar Molina]]></surname>
<given-names><![CDATA[OE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Histoplasmosis diseminada asociada a síndrome de reconstitución inmune en un paciente con virus de la inmunodeficiencia humana]]></article-title>
<source><![CDATA[Rev Cub Med Trop]]></source>
<year>2020</year>
<volume>72</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fernández Andreu]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Illnait Zaragozí]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez Machín]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Perurena Lancha]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Monroy Vaca]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Una actualización acerca de histoplasmosis]]></article-title>
<source><![CDATA[Rev Cub Med Trop]]></source>
<year>2011</year>
<volume>63</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>189-205</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fernández Andreu]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
</person-group>
<source><![CDATA[Histoplasmosis en Cuba: Contribución a su diagnóstico, prevención y control]]></source>
<year>2004</year>
<publisher-loc><![CDATA[Ciudad de La Habana ]]></publisher-loc>
<publisher-name><![CDATA[Instituto de Medicina Tropical Pedro Kourí]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fernández Andreu]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez Machín]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Illnait Zaragozí]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Perurena Lancha]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[González]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Brotes de histoplasmosis ocupacional en la provincia La Habana]]></article-title>
<source><![CDATA[Rev Cub Med Trop]]></source>
<year>2010</year>
<volume>62</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>68-72</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Voto]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[MG]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Epelbaum]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Sarkis]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Santos]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Histoplasmosis en Argentina: serie de casos en niños]]></article-title>
<source><![CDATA[Rev Iberoam Micol]]></source>
<year>2020</year>
<volume>37</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>34-6</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Batalla Garrido]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Caracterización de los pacientes diagnosticados con histoplasmosis diseminada en el Hospital Nacional de niños Dr. Carlos Sáenz Herrera en el período del 1 de enero del 2010 al 31 de diciembre del 2019]]></source>
<year>2020</year>
<publisher-loc><![CDATA[San José ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fragiel]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Lebrato]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Candel]]></surname>
<given-names><![CDATA[FJ]]></given-names>
</name>
<name>
<surname><![CDATA[Zapatero Gaviria]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[González del Castillo]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnóstico diferencial de la neumonía en los tiempos del COVID-19]]></article-title>
<source><![CDATA[Rev Esp Quimioter]]></source>
<year>2020</year>
<volume>33</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>387-9</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rueda]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Espinal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[Perfil clínico y microbiológico de los pacientes con diagnóstico confirmado, probable o posible de histoplasmosis en un centro de tercer nivel de complejidad en Bogotá D.C, Colombia]]></source>
<year>2021</year>
<publisher-name><![CDATA[Universidad Militar Nueva Granada]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[De Abreu Almeida]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Almeida-Silva]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Jefferson Guimarães]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Almeida-Paes]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Zancopé-Oliveira]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The occurrence of histoplasmosis in Brazil A systematic review]]></article-title>
<source><![CDATA[Int J Infect Dis]]></source>
<year>2019</year>
<volume>86</volume>
<page-range>147-56</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Staffolani]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Buonfrate]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Angheben]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Gobbi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Giorli]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Guerriero]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Acute histoplasmosis in immunocompetent travelers a systematic review of literature]]></article-title>
<source><![CDATA[BMC Infect Dis]]></source>
<year>2018</year>
<volume>18</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>673</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Guimarães]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Nosanchuk]]></surname>
<given-names><![CDATA[JD]]></given-names>
</name>
<name>
<surname><![CDATA[Zancopé-Oliveira]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnosis of histoplasmosis]]></article-title>
<source><![CDATA[Braz J Microbiol]]></source>
<year>2006</year>
<volume>37</volume>
<page-range>1-13</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cortés Vega]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Iraheta Nájera]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz Barahona]]></surname>
<given-names><![CDATA[Joseline]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Histoplasmosis Intestinal con síntomas de apendicitis aguda en femenina con síndrome de inmunodeficiencia adquirida: Reporte de un caso]]></article-title>
<source><![CDATA[Rev Infectio]]></source>
<year>2018</year>
<volume>22</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>167-70</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castro Castillo]]></surname>
<given-names><![CDATA[LP]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez Calcetero]]></surname>
<given-names><![CDATA[CF]]></given-names>
</name>
<name>
<surname><![CDATA[Andrés Uhia]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Gustavo Celis]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Histoplasmosis cutánea primaria. Reporte de caso]]></article-title>
<source><![CDATA[Dermatología CMQ]]></source>
<year>2020</year>
<volume>18</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>281-6</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Maldonado]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Elisiri]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández-Canigia]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Sánchez]]></surname>
<given-names><![CDATA[AV]]></given-names>
</name>
<name>
<surname><![CDATA[López]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Toranzo]]></surname>
<given-names><![CDATA[AI]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[COVID-19 associated with disseminated histoplasmosis in a kidney transplant patient]]></article-title>
<source><![CDATA[Rev Arg de Micro]]></source>
<year>2022</year>
<volume>54</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>209-14</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pérez Abreu]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez Tejeda]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Dieguez Guach]]></surname>
<given-names><![CDATA[RA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Características clínico-epidemiológicas de la COVID-19]]></article-title>
<source><![CDATA[Rev haban cienc méd]]></source>
<year>2020</year>
<volume>19</volume>
<numero>2</numero>
<issue>2</issue>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pemán]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz-Gaitán]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[García-Vidal]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Salavert]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ramírez]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Puchades]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Fungal co-infection in COVID-19 patients: Should we be concerned?]]></article-title>
<source><![CDATA[Rev Iberoam Micol]]></source>
<year>2020</year>
<volume>37</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>41-6</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bongomin]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Kwizera]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Denning]]></surname>
<given-names><![CDATA[DW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Getting Histoplasmosis on the Map of International Recommendations for Patients with Advanced HIV Disease]]></article-title>
<source><![CDATA[J. Fungi]]></source>
<year>2019</year>
<volume>5</volume>
<numero>80</numero>
<issue>80</issue>
</nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pérez]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Cáceres]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
<name>
<surname><![CDATA[Ford]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Ravasi]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez]]></surname>
<given-names><![CDATA[BL]]></given-names>
</name>
<name>
<surname><![CDATA[Pasqualotto]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Summary of Guidelines for Managing Histoplasmosis among People Living with HIV]]></article-title>
<source><![CDATA[J. Fungi]]></source>
<year>2021</year>
<numero>7</numero>
<issue>7</issue>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
