Cutaneous histoplasmosis in AIDS

Abstract

A patient with human immunodeficiency virus (HIV) infection presented with multiple cutaneous lesions on upper extremities, trunk, face and with ulcers involving oral mucosa. Histoplasma capsulatum was isolated in culture from scrapings from both cutaneous as well as oral mucosal lesions. The patient responded well initially to the treatment with Amphotericin B followed by itraconazole; however, lesions recurred after three months with the further deterioration of immune status of the patient indicated by decline in CD4 counts. The same treatment was restarted and the patient is still being followed-up.

Cutaneous histoplasmosis in a HIV seronegative patient

“…[1] In India, histoplasmosis is prevalent in the Gangetic delta. [2] We report a rare case of cutaneous histoplasmosis in a HIV seronegative patient from West Bengal, India.…”

Disseminated histoplasmosis: missed opportunistic infection in a HIV-infected patient

“…Rapid diagnosis can be established but has a high false positive rate, hence these are helpful in monitoring therapeutic response and relapse of infection 3 4…”

Unusual presentation of disseminated histoplasmosis in an immunocompetent patient

“…1 This organism is a soil-based, saprophytic fungus and is endemic throughout the Ohio and Mississippi river valleys of north America and in some parts of Africa. 3 This incidence is further decreased in immunocompetent cases. 2 Usually the patients have asymptomatic infection, however they may present with acute pulmonary disease, chronic cavitatory lung lesion, and disseminated infection.…”

“…Approximately 10% of human immunodeficiency virus (HIV) positive patients develop DH of which only 11% patients show cutaneous manifestation. 3 This incidence is further decreased in immunocompetent cases. As India is a non-endemic zone for histoplasmosis, incidence figures specific to immunocompetent persons are not certain; however, histoplasmin sensitivity has been reported to be relatively high in Calcutta and Delhi (4.7-12.3%) with most cases occurring in north-eastern India in West Bengal and Assam states.…”