Disseminated Histoplasmosis Infection in HIV-Negative Patients: Series Case and Literature Review

Ferrisse, Túlio Morandin; Rocha, Audrey Foster Lefort; Miotto, Larissa Natiele; Lança, Maria Letícia De Almeida; Massucato, Elaine Maria Sgavioli; Bufalino, Andréia

doi:10.1007/s12281-021-00414-w

Cited by 3 publications

(5 citation statements)

References 45 publications

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“…This was a case of disseminated histoplasmosis in an immunocompetent individual. Recently, there is an increasing trend of histoplasmosis infection in immunocompetent individuals, though it is more common with in HIV patients, 4,5,6 patients on steroid therapy, with malignancy and immunosuppressants and bone marrow transplantation. Initially, the patient didn’t consult a clinic since he attributed the lesions to be due to a dental procedure, but so far, no reports of histoplasmosis following the same have been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Histoplasmosis: A Mimicker of Granulomatosis with Polyangitis

Suresh,

Shylaja,

Reghukumar

et al. 2023

Indian Journal of Clinical Medicine

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A 31-year-old male from the southern part of India with no known comorbidities presented with painful oral erosions over his palate following a dental procedure. Over 2 months, it progressed to the desquamation of blackish necrotic skin, gingival hypertrophy associated with intermittent fever and odynophagia. He had elevated acute-phase reactants. Biopsy of the gingiva showed necrotising vasculitis. ANCA was weakly positive for the cytoplasmic pattern by immunofluorescence. The HRCT chest showed a single cavitating nodule in the right upper lobe and a non-cavitary nodule in the left upper lobe with right maxillary sinus thickening. With the above clinical and biopsy findings, granulomatosis with polyangiitis was the first consideration. He was referred to our centre since the oral lesions did not improve and nodular swellings developed on the palate. The examination showed cervical lymphadenopathy, which was subjected to an excision biopsy. It showed extensive areas of necrosis with karyorrhectic debris and numerous intracellular and extracellular round-to-ovoid spore-like structures. Special stains were positive for histoplasmosis. Abdomen imaging showed adrenal enlargement. Cultures were negative, which could be due to the fact that he was on multiple medications. He was treated with amphotericin and itraconazole. His symptoms improved. But later, he had worsening clinical parameters suggestive of a progressive disseminated form of histoplasmosis. In spite of aggressive efforts, he couldn’t be resuscitated owing to the dissemination of the organism. Even though considered to be more common in immunosuppressed individuals in nonendemic areas, it is reported in immunocompetent individuals as well and should be strongly suspected if the clinical picture fits so for early diagnosis and aggressive management to prevent fatal complications. There have been only fewer case reports of histoplasmosis from the southern part of India. ANCA is only rarely reported false positively in histoplasmosis.

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Section: Discussionmentioning

confidence: 99%

Histoplasmosis: A Mimicker of Granulomatosis with Polyangitis

Suresh,

Shylaja,

Reghukumar

et al. 2023

Indian Journal of Clinical Medicine

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“…The majority of cases of disseminated histoplasmosis (DH) reported in the literature involve patients living with HIV/AIDS [ 1 , 4 ]. After inhalation of fungal propagules, most people, particularly healthy individuals, remain asymptomatic or developed mild symptoms such as cough, fever, and chest pain [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Histoplasmosis is a fungal infection acquired by the inhalation of Histoplasma capsulatum conidia from the environment [ 1 ]. This dimorphic fungus has a worldwide distribution, and it is endemic in the American continent, including central areas of the USA and large parts of Latin America [ 1 ]. Even though histoplasmosis is endemic in Brazil, the diagnosis is usually performed in late stages of the disease, and the frequency of disseminated histoplasmosis is likely to be underestimated [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Disseminated histoplasmosis in a patient with chronic lymphoedema

Hatem

Pasqualotto²

2022

Medical Mycology Case Reports

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“…Once the fungus has invaded the host, it evades immune defenses, finds a niche for its growth and reproduction, and may spread or develop a latent state within granulomas 1 . Oral manifestations in the disseminated form are particularly associated with HIV infection 2 , 3 . In conclusion, oral involvement is extremely rare in immunocompetent or non-HIV-infected patients, confirming that the case reported here is rare.…”

mentioning

confidence: 99%