Acquired immunodeficiency syndrome‐related oral and/or cutaneous histoplasmosis: a descriptive and comparative study of 21 cases in French Guiana

Couppié, Pierre; Clyti, E.; Nacher, Mathieu; Aznar, Christine; Sainte‐Marie, D.; Carme, Bernard; Pradinaud, R.

doi:10.1046/j.1365-4362.2002.01590.x

Cited by 39 publications

(38 citation statements)

References 15 publications

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“…7,12,13 In agreement with these studies, the average CD4+ cell count of our patients was < 50 cells ⁄ mm 3 . 7,12,13 In agreement with these studies, the average CD4+ cell count of our patients was < 50 cells ⁄ mm 3 .…”

Section: Discussionsupporting

confidence: 92%

“…However, in immune-deficiency situations such as old age or compromised T-cell mediated immunity, the fungal infection may be widespread and potentially fatal. 7 Dermatological lesions in human immunodefiency virus -infected patients with disseminated histoplasmosis are not diagnostic, as the morphological spectrum of histoplasmosis is shared by a large number of infectious and noninfectious diseases that are common in patients with AIDS. [4][5][6] Cutaneous lesions range from papules and plaques with or without crusts, pustules and nodules to mucosal ulcers and erosions, molluscum contagiosum-like lesions, acneiform eruptions, erythematous papules and keratotic plaques.…”

Section: Introductionmentioning

confidence: 99%

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Mucocutaneous manifestations of disseminated histoplasmosis in patients with acquired immunodeficiency syndrome: particular aspects in a Latin-American population

Cunha¹,

Zampese²,

Aquino³

et al. 2007

Clin Exp Dermatol

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Mucocutaneous manifestations of disseminated histoplasmosis in patients with acquired immunodeficiency syndrome: particular aspects in a Latin-American population

Cunha¹,

Zampese²,

Aquino³

et al. 2007

Clin Exp Dermatol

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“…Naso-maxillar histoplasmosis is extremely rare; we report the first case in a non-endemic country. It has previously been described that the lower CD4 T cell count is, the higher the probability of nasal and mucous lesion as manifestation of DH [7, 9, 10]. Our patient‘s very low CD4 T cell counts supports this hypothesis.…”

Section: Discussionsupporting

confidence: 84%

Case of disseminated histoplasmosis in a HIV-infected patient revealed by nasal involvement with maxillary osteolysis

et al. 2017

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BackgroundDisseminated Histoplasmosis (DH) is a rare manifestation of Acquired Immune Deficiency Syndrome (AIDS) in European countries. Naso-maxillar osteolysis due to Histoplasma capsulatum var. capsulatum (Hcc) is unusual in endemic countries and has never been reported in European countries. Differential diagnoses such as malignant tumors, cocaine use, granulomatosis, vasculitis and infections are more frequently observed and could delay and/or bias the final diagnosis.Case presentationWe report the case of an immunocompromised patient infected by Human Immunodeficiency Virus (HIV) with naso-maxillar histoplasmosis in a non-endemic country. Our aim is to describe the clinical presentation, the diagnostic and therapeutic issues. A 53-year-old woman, originated from Haiti, was admitted in 2016 for nasal deformation with alteration of general condition evolving for at least 6 months. HIV infection was diagnosed in 2006 and classified at AIDS stage in 2008 due to cytomegalovirus infection associated with pulmonary histoplasmosis. At admission, CD4 cell count was 9/mm3. Surgical biopsies were performed and ruled out differential or associated diagnoses. Mycological cultures identified Hcc and Blood Polymerase Chain Reaction (PCR) for Hcc was positive. The patient was given daily Amphothericin B liposomal infusion during 1 month. Hcc PCR became negative in the blood under treatment, and then oral switch by itraconazole was introduced. Antiretroviral treatment was reintroduced after a 3-week histoplasmosis treatment. Normalization of naso-maxillar mucosa enabled a palatal prosthesis.ConclusionNaso-maxillar histoplasmosis is extremely rare; this is the first case ever reported in a non-endemic country. Differential diagnoses must be ruled out by conducting microbiologic tools and histological examinations on surgical biopsies. Early antifungal treatment should be initiated in order to prevent DH severe outcomes.

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“…Late-stage AIDS patients can develop a similar but distinctive presentation in which the mucocutaneous lesions are very frequent and prominent. [15][16][17] Since the appearance of AIDS, a variety of new, clinical, and histological forms of this disease have been also observed and described. Our study calls attention that despite the fact that more patients with AIDS are developing skin lesions related to H. capsulatum, most often, the diagnosis in these patients is not suspected by clinicians involved in the care of HIV+ patients.…”

Section: Discussionmentioning

confidence: 99%

New Clinical and Histological Patterns of Acute Disseminated Histoplasmosis in Human Immunodeficiency Virus–Positive Patients With Acquired Immunodeficiency Syndrome

Sierra¹,

Torres²

2013

The American Journal of Dermatopathology

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Histoplasmosis has attained increasing relevance in the past 3 decades because of the appearance of the human immunodeficiency virus (HIV). In most immunocompetent persons, the infection is asymptomatic or can produce a respiratory condition with symptoms and radiological images similar to those observed in pulmonary tuberculosis; in non-HIV+ immunocompromised patients, it can cause respiratory symptoms or evolve into a disseminated infection. The same can occur in acquired immunodeficiency syndrome (AIDS) patients. We have observed a series of HIV+ patients with AIDS who presented with cutaneous histoplasmosis and in whom the clinical and histopathological features were highly unusual, including variable mucocutaneous lesions that were difficult to diagnose clinically. These patients displayed unusual, previously undescribed, histological patterns, including lichenoid pattern, nodular pseudomyxoid pattern, pyogenic granuloma-like pattern, perifollicular pattern, and superficial (S), mid (M), and deep perivascular dermatitis; and more commonly encountered patterns, such as histiocytic lobular panniculitis and focal nodular dermatitis. The novel histopathological patterns of cutaneous involvement by histoplasmosis seen in these patients resembled other common inflammatory and infectious conditions and required a high level of suspicion and the application of special stains for organisms for confirmation. These new, clinical, and histological findings do not seem to be commonly encountered in HIV- patients infected with the fungus but seem to be displayed most prominently in HIV+ patients with AIDS.

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Acquired immunodeficiency syndrome‐related oral and/or cutaneous histoplasmosis: a descriptive and comparative study of 21 cases in French Guiana

Cited by 39 publications

References 15 publications

Mucocutaneous manifestations of disseminated histoplasmosis in patients with acquired immunodeficiency syndrome: particular aspects in a Latin-American population

Mucocutaneous manifestations of disseminated histoplasmosis in patients with acquired immunodeficiency syndrome: particular aspects in a Latin-American population

Case of disseminated histoplasmosis in a HIV-infected patient revealed by nasal involvement with maxillary osteolysis

New Clinical and Histological Patterns of Acute Disseminated Histoplasmosis in Human Immunodeficiency Virus–Positive Patients With Acquired Immunodeficiency Syndrome

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