Histoplasmosis is considered a fairly rare imported mycosis in Chinese. But with the increased communication and great development of international trade and commerce, especially the ‘belt and road’ construction in China, an outbreak of imported acute pulmonary histoplasmosis has occurred. As well known, in the immunocompetent host, exposure to Histoplasma microconidia is usually responsible for a symptomless presentation or flu-like syndrome. But acute onset of pulmonary histoplasmosis is very rare. Here we report twelve Chinese miners in Guiana who were immunocompetent before going abroad. Twelve patients reported working in an abandoned mine cave infested by bats in Guiana 3–14 days prior to onset of symptoms.Exposure lasted from several minutes to 10 days. All patients were received short-term treatment at Guiyana，but the therapeutic effect were poor for no targeted treatment was adopted before defining the infectious cause. Consequently，two patients immediately died shortly after onset from this diseases of unknown origin in Guiana.Luckly, the rest suffers were escorted to our hospital by special airplane approved by the Chinese government. Through well-planned and organized，emergent diagnosis and precise treatment by national and provincial expert group meetings, nine cases were cured(the cure rate 75.0%,9/12) and one became a vegetative state(the mortality rate was 16.7%,2/12). Final definite diagnosis of acute pulmonary histoplasmosis were made.The cause of this imported epidemic outbreak was probably related with the inhalation of spores of Histoplasma capsulatumcontained in bat guano in the abandoned mines in Guiyana. This article highlights the need to improve personal protective equipmentand to increase awareness of the disease for the prevention from the recurrence of the next outbreak. Even more importantly，we provide a good example by international first aid for this endemic mycosis.
Keywords: acute pulmonary histoplasmosis, imported, outbreak, immunocompetent miners, Guiana