Disseminated histoplasmosis as the first presentation of idiopathic CD4+ T-lymphocytopenia

Relia, Nitin; Kavimandan, A.; Sinha, Sanjeev; Sharma, Saurabh

doi:10.4103/0022-3859.62426

Cited by 8 publications

(3 citation statements)

References 5 publications

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“…Manifestations reported include nasal polypoid tumors, 88 otitis media, 53 laryngeal papillomas, 63 reticulonodular infiltrates, 89 pneumonia, bronchiectasis, 53 nodules, masses, 90 cysts, mediastinal lymphadenopathy, 75 pleural effusion, 91 and empyema. 92 Organisms comprised of mycobacteria (M. tuberculosis, MAC), bacteria (Nocardia, 71 H. infleunzae), viruses (VZV, CMV, HPV, and EBV) and fungi (Pneumocystis jirovecii, 75 cryptococcosis, mucormycosis, aspergillosis, istoplasmosis 72 ). According to Ahmad et al, Pneumocystis jirovecci was the most common respiratory pathogen.…”

Section: Infectionsmentioning

confidence: 99%

<p>Idiopathic CD4 Lymphocytopenia: Current Insights</p>

Vijayakumar¹,

Viswanathan²,

Aghoram³

2020

ITT

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Idiopathic CD4 lymphocytopenia is a condition characterized by low CD4 counts. It is rare and most of the information about this illness comes from case reports. Presentation is usually in the 4th decade of life with opportunistic infections, autoimmune disease or neoplasia. The pathophysiology of this condition is not well understood. Management revolves around treatment of the presenting condition and close follow-up of these patients. This review presents a narrative summary of the current literature on idiopathic CD4 lymphocytopenia.

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Section: Infectionsmentioning

confidence: 99%

<p>Idiopathic CD4 Lymphocytopenia: Current Insights</p>

Vijayakumar¹,

Viswanathan²,

Aghoram³

2020

ITT

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“…Our patient had CD4 counts of only 53 /µL and 250/ µL on two occasions, 3 months apart and HIV 1 and 2 were negative suggesting the diagnosis of idiopathic CD4 lymphocytopenia [11]. Two similar cases of idiopathic CD4 lymphocytopenia with disseminated histoplasmosis were also reported from India [12,13]. The diagnostic criteria of this condition are absolute CD4 T lymphocyte count <300/µl or <20% of total T cells on two occasions in the absence of HIV 1 and 2 infection and other immunosuppressive conditions [11].…”

Section: Discussionmentioning

confidence: 57%

Progressive disseminated histoplasmosis in idiopathic CD4 lymphocytopenia an underdiagnosed combination - a case report

Yadav

Kumar

Bohra

et al. 2021

Medicine and Pharmacy Reports

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Progressive disseminated histoplasmosis (PDH) usually presents as fever, anemia, leukopenia, hepatosplenomegaly, lymphadenopathy and pulmonary symptoms. There are few reports showed the association of Idiopathic CD4 lymphocytopenia (ICL) with histoplasmosis. We describe a 65-year-old female presented with history of fever, papulo-nodular rash and significant weight loss and diagnosed as progressive disseminated histoplasmosis. All immunocompromised conditions were ruled out. In addition, her 2 consecutive CD4 counts were below 300. The patient was diagnosed with PDH associated with ICL. Patient showed significant improvement with liposomal amphotericin B and itraconazole. Absolute CD4 counts should be done in all cases of progressive disseminated histoplasmosis even in HIV negative individuals to rule out associated ICL.

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“…Histoplasma is a ubiquitous dimorphic fungus that is present in the soil. Patients are at a higher risk of developing histoplasmosis if the CD4 count is less than 150/ul [ 8 ]. Progressive disseminated histoplasmosis (PDH) from gastrointestinal standpoint may be characterized by weight loss, oral ulcers, diarrhea, jaundice, pancytopenia and hepatosplenomegaly [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Disseminated Histoplasmosis Involving Soft Palate, Duodenum, Sigmoid Colon and Bone Marrow in a Patient With Isolated CD4+ T-Lymphocytopenia

Samji¹,

Verma²,

Mohammed³

et al. 2021

Cureus

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Idiopathic CD4 T-lymphocytopenia (ICL) is a rare entity that is associated with decreased immunity which predisposes affected individuals to opportunistic infections and malignancies. Autoimmune conditions are common in patients with ICL and they are considered part of its clinical spectrum as well. Treatment of ICL includes treatment of opportunistic infections and prophylaxis against them. Some cases are self-limited while others require long-term monitoring. We present a case of a 60-year-old man who was diagnosed with disseminated histoplasmosis involving soft palate, duodenum, colon and bone marrow in the setting of idiopathic CD4 T-lymphocytopenia.

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Disseminated histoplasmosis as the first presentation of idiopathic CD4+ T-lymphocytopenia

Cited by 8 publications

References 5 publications

<p>Idiopathic CD4 Lymphocytopenia: Current Insights</p>

<p>Idiopathic CD4 Lymphocytopenia: Current Insights</p>

Progressive disseminated histoplasmosis in idiopathic CD4 lymphocytopenia an underdiagnosed combination - a case report

Disseminated Histoplasmosis Involving Soft Palate, Duodenum, Sigmoid Colon and Bone Marrow in a Patient With Isolated CD4+ T-Lymphocytopenia

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