Memoria CD.indd - ISHAM

Historical accountsHistoplasmosisHistoplasmosis: Discovery in PanamaMarion Clarke MartinMicrobiology Department, Faculty of Medicine,University of Panama--Panamae-mail: marionma38@yahoo.comThe discovery of histoplasmosis in Panama is closely linked to the history of the Republic ofPanama, since the first case of this disease, worldwide, was diagnosed by Samuel T. Darling in1905 in a Martinique man employed in the construction of the Panama Canal. Panama becamean independent republic after separation from Colombia in 1903, and in 1904, a second attemptat building the Canal was made by the United States of America, after the French failed at thisendeavor in the nineteenth century. Since the discovery of this disease on the Isthmus of Panamaa little over a hundred years ago, cases spanning the complete spectrum of histoplasmosis -fromthe asymptomatic infection through a mild flu-like illness to full-blown, disseminated disease asdescribed in the first diagnosed case -have been documented in the population of all ages, frominfants to senior citizens, and even in a dog (1945).During the eight months following the first case, Darling diagnosed two additional cases. Twentyyears later (1926), the fourth case worldwide was identified in Minnesota, USA, and in 1934Robert De Monbreun isolated the etiologic agent, the dimorphic fungus Histoplasma capsulatum.Christie and Peterson demonstrated for the first time in 1945 that skin sensitivity to histoplasminwas common in Tennessee in persons with lung calcifications and negative tuberculin reactions;and by the following year, 1946, it was evident that histoplasmosis was most likely a very common,usually asymptomatic infection in endemic areas, and not a rare, deadly illness.In light of the foregoing, investigators in Panama began work in this field, and Mastellari, a specialistin chest diseases, demonstrated (1948) histoplasmin sensitivity prevalence in 48% of childrenbetween 5 and 14 years of age. Various studies published between 1950 and 1964 haveestablished the prevalence of histoplasmin sensitivity at 50 – 85% of the Panamanian population;and later work done by us has generally confirmed these data. However, in the 80s we noticed107