Histoplasmosis

Tewari, Ram P.; Wheat, L. Joseph; Ajello, Libero

doi:10.1002/9780470688618.taw0154

Cited by 9 publications

(9 citation statements)

References 90 publications

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“…The Penicillium marneffei yeast forms replicate by binary division and have a septate appearance, whereas H. capsulatum divides by narrowbased budding [47]. In the case of histoplasmosis, as noted in our case report, numerous small 2-4 µm in diameter yeast-like microorganisms may be seen within macrophage, multinucleate giant cells, or within fibrous tissue [48]. Patients who have hilar lymphadenopathy, arthralgia, and erythema nodosum can be mistakenly given the diagnosis of sarcoidosis [49,50].…”

Section: Differential Diagnosismentioning

confidence: 57%

Pulmonary Histoplasmosis in a patient with Cough, Dyspnea, Pulmonary Nodule and Rheumatologic Manifestations: Case Report and Review

Britto¹

2018

JRI

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Histoplasmosis has worldwide distribution, occurring most commonly in North, Central, and South America, as well as parts of Africa and Asia [1, 2]. Histoplasmosis is a granulomatous disease caused by a dimorphic fungus Histoplasma capsulatum (H. capsulatum). There are two varieties of H. capsulatum that are pathogenic to humans, H. capsulatum var. capsulatum and H. capsulatum var. duboisii. H. capsulatum var. capsulatum is endemic in eastern United States and Latin America [3], and H. capsulatum var. duboisii is prevalent in Africa and South East Asia [4]. In the United States, H. capsulatum is primarily seen in Mississippi and Ohio River valleys. H. capsulatum grows best in soil contaminated with bird or bat droppings [5]. Transmission occurs via inhalation of H. capsulatum spores from the soil. Sites commonly associated with exposure to H. capsulatum include old buildings, caves, bridges, where birds have roosted [6, 7]. Infection may be acquired from exposure to outdoor activities such as exploring caves, construction, remodeling, demolition, bird handling, all of which can cause inhalation of the pathogen through the contaminated soil [8, 9]. The variation in clinical course due to histoplasmosis depends on the extent of the exposure to the organism. Histoplasmosis may remain asymptomatic in most healthy individuals following low-level exposure and asymptomatic pulmonary histoplasmosis is the most common syndrome following infection [10]. Fewer than five percent of exposed individuals develop symptomatic disease after a low level exposure to H. capsulatum [11]. Symptomatic infection usually causes self-limited pulmonary illnesses, rheumatologic manifestations such as arthritis or arthralgia involving the large or small joints, dermatologic manifestations such as erythema nodosum and/or erythema multiforme or pericarditis. Exposure to heavy inoculum can cause diffuse pulmonary involvement [12]. Individuals at the extremes of age or with underlying immunosuppressive conditions can develop progressive disseminated disease. Histoplasmosis can involve every organ system during the course of dissemination [13]. Here, we describe a case of pulmonary histoplasmosis in a healthy adult female presenting with cough, dyspnea, pulmonary nodule and rheumatologic manifestations.

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Section: Differential Diagnosismentioning

confidence: 57%

Pulmonary Histoplasmosis in a patient with Cough, Dyspnea, Pulmonary Nodule and Rheumatologic Manifestations: Case Report and Review

Britto¹

2018

JRI

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“…Histoplasmosis is an uncommon fungal disease caused by Histoplasma capsulatum var capsulatum and Histoplasma capsulatum var duboisii [11,12]. Yeast forms of this fungus replicate within the reticuloendothelial system and disseminate in the absence of a good immune status.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Manifestation of Underlying Disseminated Histoplasmosis in an Immunocompetent Host of Nonendemic Area with Reversible CD4 Cell Depletion and its Recovery on Antifungal Therapy

2015

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We present the case of an 18-year-old male patient admitted with complaints of fever and rapid weight loss since 3 months. Patient had multiple umbilicated papular to nodular lesions over chin and forehead region. Complete blood count revealed bicytopenia. An excisional biopsy of the skin lesions had revealed cutaneous histoplasmosis. On further investigations for bicytopenia, histoplasmosis had been diagnosed on bone marrow trephine biopsy. For the immune status, patient's serology against HIV was negative and his CD4 lymphocyte counts were low at 161. Patient received antifungal therapy including amphotericin B and itraconazole. He showed remarkable improvement in his general condition and blood counts. A repeat CD4 count showed normal counts, and idiopathic CD4 lymphocytopenia was excluded. Disseminated histoplasmosis presenting as cutaneous lesions in an immunocompetent host is very rare, and we are not aware of any case report in the literature where there is reversible depletion of CD4 counts following antifungal treatment in an immunocompetent host of nonendemic area.

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“…5,6 Mycelia are the naturally infectious forms and have microconidia and macroconidia forms. 1 The mode of infection is by inhalation of the mold microconidia which are small enough to reach the terminal bronchioles and alveoli.…”

Section: Discussionmentioning

confidence: 99%

Histoplasmosis in an immunocompetent host: a rare case report

et al. 2017

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Histoplasmosis, a systemic mycosis caused by Histoplasma capsulatum manifests clinically in immunocompromised patients as acute or chronic pulmonary infection or as a progressive disseminated disease. In immunocompetent hosts, the disease is usually self-limited or presents as flu-like symptoms. It is endemic in North, Central and South America as well as parts of Europe and Africa. We report a case of a 76-year-old diabetic, HIV negative patient who presented with white nodular patches on the tongue and gingiva which were reported as histoplasmosis on histopathology. He also had idiopathic CD4 lymphocytopenia and thrombocytopenia.

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Histoplasmosis

Cited by 9 publications

References 90 publications

Pulmonary Histoplasmosis in a patient with Cough, Dyspnea, Pulmonary Nodule and Rheumatologic Manifestations: Case Report and Review

Pulmonary Histoplasmosis in a patient with Cough, Dyspnea, Pulmonary Nodule and Rheumatologic Manifestations: Case Report and Review

Cutaneous Manifestation of Underlying Disseminated Histoplasmosis in an Immunocompetent Host of Nonendemic Area with Reversible CD4 Cell Depletion and its Recovery on Antifungal Therapy

Histoplasmosis in an immunocompetent host: a rare case report

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