Disseminated histoplasmosis in an immunocompetent patient with COVID-19 pneumonia

Nogal, Genesis Perez Del; Mata, A. Dávalos; Ernest, Prince; Salinas, Ivania

doi:10.1136/bcr-2021-247617

Cited by 15 publications

(9 citation statements)

References 19 publications

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“…Similar reports are published in the literature by authors who encountered COVID-19 infected individuals with superimposed histoplasmosis [11][12][13] . These cases had all the signs and symptoms of respiratory syndrome similar to those other ARDS cases.…”

Section: Discussionsupporting

confidence: 86%

Histoplasmosis in nasopharynx clinically mistaken for nasopharyngeal malignancy

Pol¹,

Patil²,

Pol³

et al. 2023

Romanian Journal of Rhinology

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Histoplasmosis is a rare type of fungal infection which may manifest as a respiratory disease or as a disseminated infection. It is common in immunocompromised patients and, in recent times, seen in association with COVID-19. On histopathological examination, many intracellular and extracellular yeast forms are seen, which can be confirmed by fungal stains. Histoplasmosis involving the nasopharyngeal region is quite rare. Till date, only less than 100 cases of pharyngo-laryngeal histoplasmosis have been reported. Such cases are clinico-radiologically easily and frequently mistaken for malignancy. Here, we report a case that initially had COVID-19-like symptoms and later presented with a nasopharyngeal mass clinico-radiologically mistaken as a nasopharyngeal malignancy. The diagnosis was established on histopathological examination and the patient recovered completely with anti-fungal treatment. A high grade of suspicion and thorough histopathological examination, especially in immunocompromised patients, complimented by fungal special stains is quite rewarding as even a disseminated disease is curable.

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Section: Discussionsupporting

confidence: 86%

Histoplasmosis in nasopharynx clinically mistaken for nasopharyngeal malignancy

Pol¹,

Patil²,

Pol³

et al. 2023

Romanian Journal of Rhinology

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“…A case study reported that a 61‐year‐old man was admitted to the hospital due to Covid‐19 pneumonia, and despite appropriate management, the patient was transferred to ICU for mechanical ventilation due to the development of respiratory failure. After 2 weeks, co‐infection with pulmonary histoplasmosis was detected, which was treated by itraconazole and amphotericin B, and the patient dramatically improved 70 . Furthermore, anti‐TNF‐α antagonist tocilizumab, effectively used in Covid‐19 patients to prevent cytokine storm, 70 increases the risk for activation of latent pulmonary histoplasmosis as reported in the case study 71 .…”

Section: Covid‐19 and Pulmonary Histoplasmosismentioning

confidence: 82%

“…A cohort study Anti-H. capsulatum antibodies are present in 20.51% of Covid-19 patients Toscanini et al 68 A case study Co-infection with pulmonary histoplasmosis was detected in Covid-19 patients. Del Nogal et al 70 Review Pulmonary histoplasmosis is linked with rehospitalization in recovered patients from Covid-19.…”

Section: Study Type Findings Referencementioning

confidence: 99%

“…After 2 weeks, co‐infection with pulmonary histoplasmosis was detected, which was treated by itraconazole and amphotericin B, and the patient dramatically improved 70 . Furthermore, anti‐TNF‐α antagonist tocilizumab, effectively used in Covid‐19 patients to prevent cytokine storm, 70 increases the risk for activation of latent pulmonary histoplasmosis as reported in the case study 71 . Of interest, pulmonary histoplasmosis and other fungal infections could potentially cause rehospitalization in recovered patients from Covid‐19 pneumonia, mainly in elderly subjects due to post‐Covid‐19 syndrome 72 .…”

Section: Covid‐19 and Pulmonary Histoplasmosismentioning

confidence: 99%

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Insights on Covid‐19 with superimposed pulmonary histoplasmosis: The possible nexus

Almutawif,

Al‐kuraishy,

Al‐Gareeb

et al. 2023

Immunity Inflam & Disease

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A novel coronavirus (CoV) known as severe acute respiratory syndrome CoV type 2 is the causative agent for the development of CoV disease 2019 (Covid‐19). Covid‐19 may increase the risk of developing pulmonary histoplasmosis due to immune dysregulation. In addition, Covid‐19 may enhance the propagation of acute pulmonary histoplasmosis due to lung injury and inflammation, and using corticosteroids in severely affected Covid‐19 patients may reactivate latent pulmonary histoplasmosis. Likewise, activation of inflammatory signaling pathways during H. capsulatum infection may increase the severity of Covid‐19 and vice versa. Furthermore, lymphopenia in Covid‐19 may increase the risk for the progress of pulmonary histoplasmosis besides activation of inflammatory signaling pathways during H. capsulatum infection may increase the severity of Covid‐19 and vice versa. Therefore, this critical review aimed to find the potential link between Covid‐19 pneumonia and pulmonary histoplasmosis concerning the immunological response.

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“…increases the severity of symptoms such as respiratory failure. To lower the risk of death from such infections, effective and proactive diagnosis and treatment are required [ 55 ]. Those with severe COVID-19 and those receiving large dosages of steroids and immunosuppressants are among the groups at risk for developing histoplasmosis [ 56 ].…”

Section: Fungal Infections In Covid-19 Patientsmentioning

confidence: 99%

Post-COVID-19 Fungal Infection in the Aged Population

et al. 2023

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Coronavirus disease 2019 (COVID-19) infection is currently a great cause of concern for the healthcare sector around the globe. SARS-CoV-2 is an RNA virus that causes a serious infection that is associated with numerous adverse effects and multiple complications associated with different organs and systems during its pathogenic cycle in humans. Individuals affected by COVID-19, especially elderly populations and immunocompromised people, are greatly vulnerable to opportunistic fungal pathogens. Aspergillosis, invasive candidiasis, and mucormycosis are widespread fungal coinfections in COVID-19 patients. Other fungal infections that are rare but are exhibiting increased incidence in the current scenario include infections caused by Pneumocystis jirovecii, Histoplasma sp., Cryptococcus sp., etc. By producing virulent spores, these pathogens increase the severity of the disease and increase the morbidity and fatality rates in COVID-19 patients globally. These infections generally occur in patients recovering from COVID-19 infection, resulting in rehospitalization. Older and immunocompromised individuals are at higher risk of developing opportunistic fungal infections. This review focuses on understanding the opportunistic fungal infections prevalent in COVID-19 patients, especially elderly people. We have also highlighted the important preventive methods, diagnostic approaches, and prophylactic measures for fungal infections.

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Disseminated histoplasmosis in an immunocompetent patient with COVID-19 pneumonia

Cited by 15 publications

References 19 publications

Histoplasmosis in nasopharynx clinically mistaken for nasopharyngeal malignancy

Histoplasmosis in nasopharynx clinically mistaken for nasopharyngeal malignancy

Insights on Covid‐19 with superimposed pulmonary histoplasmosis: The possible nexus

Post-COVID-19 Fungal Infection in the Aged Population

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