Disseminated Histoplasmosis in Children: The Role of Itraconazole Therapy

Tobón, Ángela M.; Franco, Lilliana; Espinal, David; Gómez, Iván; Arango, Myrtha; Trujillo, Hugo; Restrepo, Ángela

doi:10.1097/00006454-199611000-00014

Cited by 42 publications

(17 citation statements)

References 13 publications

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“…Los Doctores Dodd y Tompkins en 1934, realizan por primera vez el diagnóstico en un niño. 3 Son pocos los casos de la forma diseminada en pacientes inmunocompetentes reportados hasta el momento en Colombia [6][7][8] . En los últimos años la incidencia en todos los grupos de edad viene en aumento, gracias a enfermedades que cursan con inmunocompromiso (asociado principalmente a infección por el virus de inmunodeficiencia humana -VIH) 3,10,11 o al uso de citotóxicos e inmunosupresores, especialmente micofenolato [11][12][13] .…”

Section: Discussionunclassified

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Histoplasmosis aguda diseminada en un niño inmunocompetente

Forero-Manzano

Niederbacher-Velásquez

Otoya-Castrillón

et al. 2017

Infect

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ResumenLa histoplasmosis es una patología endémica en Colombia. La verdadera incidencia en nuestro país es desconocida. En niños inmunocompetentes generalmente es un proceso autolimitado. Algunos casos pueden resultar un dilema diagnóstico por su amplio espectro de manifestaciones clínicas y diagnósticos diferenciales o por las dificultades de su confirmación sobre todo en zonas endémicas. Describimos el caso de un niño inmunocompetente con histoplasmosis diseminada aguda e importante compromiso respiratorio resaltando los dilemas que podrían presentarse en su diagnóstico y manejo.Palabras clave: Histoplasmosis; niños; inmunocompetente. Acute disseminated histoplasmosis in an immunocompetent child AbstractHistoplasmosis is an endemic pathology in Colombia but its real incidence in the country is unknown. In non-immunocompromised children, the mycosis is mainly a self-limited process. In endemic zones certain cases may represent a diagnostic dilemma due to the broad spectrum of clinical manifestations that complicate differential diagnosis and hinder the proper diagnosis. We describe the case of an immunocompetent child diagnosed with acute disseminated histoplasmosis who exhibited extensive respiratory involvement highlighting the dilemmas faced when attempting to establish the diagnosis and defining management.

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Section: Discussionunclassified

“…4,5 Pocos casos han sido descritos en Colombia en la población pediátrica y menos aún en inmunocompetentes. [6][7][8] Se describe el caso de un niño con diagnóstico de histoplasmosis aguda diseminada con importante compromiso respiratorio.…”

Section: Introductionunclassified

Histoplasmosis aguda diseminada en un niño inmunocompetente

Forero-Manzano

Niederbacher-Velásquez

Otoya-Castrillón

et al. 2017

Infect

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“…capsulatum and Histoplasma capsulatum var. duboisii that cause disease in humans 2 The disease is classified into acute pulmonary histoplasmosis (normal host), disseminated histoplasmosis (immune defect) and chronic pulmonary histoplasmosis (structural defect) 3,4,5 . The acute histoplasmosis is usually asymptomatic, occasionally symptomatic but complications are rare 3 .…”

Section: Introductionmentioning

confidence: 99%

“…The time course of the infection in these patients is measured in months, and the disease is uniformly fatal if not treated 4 . We report a case of disseminated histoplasmosis in a 13-year-old girl that mimicked a number of clinical conditions.…”

Section: Introductionmentioning

confidence: 99%

Disseminated Histoplasmosis in a 13-year-old girl: A case report

Ubesie¹,

Okafo²,

Ibeziako³

et al. 2013

Afr H. Sci.

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Background: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immunecompromised individuals such as those with acquired immuno-deficiency syndrome. Objective: To describe a case of disseminated histoplasmosis in an adolescent girl. Method: We report a case of disseminated histoplasmosis in a 13-year-old adolescent girl. She was admitted for 16 days because of neck masses of 3 years duration, generalized body swelling of 3 months and reduction in urinary output of 2 months. She tested negative for human immunodeficiency virus antibodies. Result: An autopsy was performed because a definitive diagnosis could not be made while the patient was still alive. The autopsy revealed central caseating areas in the lymph nodes and membranoproliferative glomerulonephritis. The periodic acid-Schiff staining technique for tissues showed viable yeast cells suggestive of histoplasmosis. Zeihl-Neelsen's staining for mycobacteria tuberculosis was negative. Conclusion: Undiagnosed case of disseminated histoplasmosis while the patient was alive is being reported in a 13-yearold girl. Disseminated histoplasmosis should be considered as a differential diagnosis of childhood chronic infections and malignancies as in Nigeria.

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“…Several investigators have found evidence supporting the possibility that airborne secondary metabolites produced by fungi, i.e., mycotoxins, and (1--3)-P-Dglucans, present in the cell wall of most filamentous fungi, may contribute to respiratory symptoms (6)(7)(8)(9). Opportunistic fungal infections are rare in children but may occur in the immunocompromised (10)(11)(12)(13).…”

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confidence: 99%

Review of methods applicable to the assessment of mold exposure to children.

Dillon

Miller

Sorenson

et al. 1999

Environ Health Perspect

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This article presents discussion of the assessment of the exposure of children to fungi, substances derived from fungi, and the environmental conditions that may lead to exposure. The principles driving investigations of fungal contamination and subsequent exposure are presented as well as guidelines for conducting these investigations. A comprehensive description of available research sampling and analysis techniques is also presented.

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Disseminated Histoplasmosis in Children: The Role of Itraconazole Therapy

Abstract: The results of this study indicate that itraconazole is effective for treatment of disseminated childhood histoplasmosis. More studies should be performed to determine the most appropriate dosage and the optimal duration of itraconazole treatment in children.

Cited by 42 publications

References 13 publications

Histoplasmosis aguda diseminada en un niño inmunocompetente

Histoplasmosis aguda diseminada en un niño inmunocompetente

Disseminated Histoplasmosis in a 13-year-old girl: A case report

Review of methods applicable to the assessment of mold exposure to children.

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