Disseminated histoplasmosis in a kidney liver transplant patient from a non-endemic area: A diagnostic challenge

Carmans, L.; Craenenbroeck, Amaryllis H. Van; Lagrou, Katrien; Deroose, Christophe M.; Wolthuis, Albert; Wijngaerden, Eric Van

doi:10.1016/j.idcr.2020.e00971

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…A majority of cases were diagnosed by means of histology (22, 78.6%) associated with cultures (13, 46.4%) or PCR (10, 35.7%); in two patients, the diagnosis was confirmed by a post mortem examination [20,89]. The use of PCR was reported in 11 cases [44,71,76,84,86,88,[90][91][92][93][94]. Two cases were positive for urinary Histoplasma antigen [74,75].…”

Section: Patients With Other Immunocompromising Conditions (Oic)mentioning

confidence: 99%

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Antinori

Giacomelli

Corbellino

et al. 2021

JoF

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Human histoplasmosis is a mycosis caused by two distinct varieties of a dimorphic fungus: Histoplasma capsulatum var. capsulatum and H. capsulatum var. duboisii. In Europe, it is usually imported by migrants and travellers, although there have been some autochthonous cases, especially in Italy; however, most European physicians are unfamiliar with its clinical and pathological picture, particularly among immunocompromised patients without HIV infection. This systematic review of all the cases of histoplasmosis reported in Europe and Israel between 2005 and 2020 identified 728 cases diagnosed in 17 European countries and Israel described in 133 articles. The vast majority were imported (mainly from Central and South America), but there were also seven autochthonous cases (six in Europe and one in Israel). The patients were prevalently males (60.4%), and their ages ranged from 2 to 86 years. The time between leaving an endemic region and the diagnosis of histoplasmosis varied from a few weeks to more than 40 years. Progressive disseminated histoplasmosis was the most frequent clinical picture among people living with HIV infection (89.5%) or a different immunocompromising condition (57.1%), but it was also recorded in 6.2% of immunocompetent patients. Twenty-eight cases were caused by Histoplasma duboisii. Immunocompromised patients without HIV infection had the worst outcomes, with a mortality rate of 32%.

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Section: Patients With Other Immunocompromising Conditions (Oic)mentioning

confidence: 99%

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Antinori

Giacomelli

Corbellino

et al. 2021

JoF

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“…There were 172 cases of histoplasmosis described in 125 reports [ 66 , 69 , 72–87 , 90–99 , 101–182 , 194 , 196 , 197 , 199–206 , 208 , 241–243 ] ( Table 1 ). Half of recipients (74 of 144 [51.4%]) were on MMF [ 73 , 74 , 80 , 83–86 , 92–94 , 96 , 98 , 101–104 , 107–109 , 113–116 , 118–120 , 122 , 126 , 130 , 132–135 , 140 , 143 , 145 , 148–150 , 152 , 153 , 155 , 156 , 159 , 161–165 , 172–174 , 177 , 179 , 181 , 194 , 196 , 197 , 204 ]. T-cell–depleting induction was reported in 23 cases [ 78 , 104 , 107 , 108 , 110 , 113–115 , 118 , 125 , 133 , 146 , 154 , 163 ] while acute rejection occurred in 30 recipients within 1–3 months before symptom onset […”

Section: Resultsmentioning

confidence: 99%

Clinical Characteristics and Outcomes of Endemic Mycoses After Solid Organ Transplantation: A Comprehensive Review

Abad,

Razonable

2024

Open Forum Infectious Diseases

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Background Geographically endemic fungi can cause significant disease among solid organ transplant (SOT) recipients. We provide an update on the epidemiology, clinical presentation and outcomes of 5 endemic mycoses in SOT recipients. Methods Multiple databases were reviewed from inception through May 2023 using key words for endemic fungi (e.g. Coccidioidomycosis or Coccidioides, Histoplasmosis or histoplasma, etc.). We included adult SOT recipients and publications in English or with English translation. Results Among 16 cohort studies that reported on blastomycosis (n=3), coccidioidomycosis (n=5), histoplasmosis (n=4), and various endemic mycoses (n=4), the incidence rates varied: coccidioidomycosis (1.2-5.8%); blastomycosis (0.14-0.99%) and histoplasmosis (0.4-1.1%). There were 204 reports that described 268 unique cases of endemic mycoses, including 172 histoplasmosis, 31 blastomycosis, 34 coccidioidomycosis, 6 paracoccidioidomycosis, and 25 talaromycosis. The majority of patients were male (176/261, 67.4%). Transplanted allografts were mostly kidney (191/268, 71.3%), followed by liver (n=39, 14.6%), heart (n=18, 6.7%), lung (n=13, 4.9%), combined kidney-liver, and kidney-pancreas (n=6, 2.7%). In all five endemic mycoses, most patients presented with fever (162/232, 69.8%) and disseminated disease (179/268, 66.8%). Cytopenias were frequently reported for histoplasmosis (71/91, 78.0%), coccidioidomycosis (8/11, 72.7%) and talaromycosis (7/8, 87.5%). Graft loss was reported in 12/136 patients (8.8%). All-cause mortality was reported in 71/267 (26.6%); half (n=34, 50%) of the deaths were related to the underlying mycoses. Conclusions Endemic mycoses commonly present with fever, cytopenias and disseminated disease in SOT recipients. There is a relatively high rate of all-cause mortality, including many that were attributed to endemic mycoses.

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Mycophenolate-mofetil/tacrolimus

2021

Reactions Weekly

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Disseminated histoplasmosis in a kidney liver transplant patient from a non-endemic area: A diagnostic challenge

Cited by 3 publications

References 16 publications

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Clinical Characteristics and Outcomes of Endemic Mycoses After Solid Organ Transplantation: A Comprehensive Review

Mycophenolate-mofetil/tacrolimus

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