Histoplasmosis in children

Fischer, Gilberto Bueno; Mocelin, Helena Teresinha; Severo, Cecília Bittencourt; Oliveira, Flávio de Mattos; Xavier, Melissa Orzechowski; Severo, Luiz Carlos

doi:10.1016/j.prrv.2009.08.002

Cited by 42 publications

(56 citation statements)

References 21 publications

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“…Histoplasmosis is acquired by inhaling microconidia, and depending on the amount of fungus inhaled and immune status, the host may show no symptoms or may have acute or chronic pulmonary disease or disseminated infection (22,78). Once inhaled, the conidia are ingested by lung alveolar macrophages, where the organisms convert into the yeast phase.…”

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

“…The collections of macrophages distort the organ architecture and produce necrotic areas. Because the morphol- (22,60): the small variant of B. dermatitidis (in these cases the presence of broad-based budding and seeking larger forms can be helpful in making the diagnosis of blastomycosis), capsule-deficient cryptococci (in these cases size variation and looking for weakly positive mucicarmine-staining yeasts may suggest the diagnosis of cryptococcosis), endospores of Coccidioides spp. (looking for remnants of a ruptured spherule or an intact spherule is paramount for diagnosis of coccidioidomycosis), Pneumocystis jirovecii (this organism lacks budding and has an intracystic focus), Penicillium marneffei (this organism shows formation of a transverse septum rather than budding), and Candida glabrata (this organism may show more size variability than in histoplasmosis, and the inflammation is primarily neutrophilic).…”

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

“…Furthermore, the organism grows slowly, so cultures require incubation for 4 to 6 weeks before they are called negative (77). Although testing for antibodies can be performed using complement fixation or immunodiffusion, production of antibodies may not occur in immunodeficient patients (22,78). False-positive serology can occur in patients with lymphoma, tuberculosis, and other fungal infections, particularly blastomycosis.…”

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

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Histopathologic Diagnosis of Fungal Infections in the 21st Century

2011

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SUMMARY Fungal infections are becoming more frequent because of expansion of at-risk populations and the use of treatment modalities that permit longer survival of these patients. Because histopathologic examination of tissues detects fungal invasion of tissues and vessels as well as the host reaction to the fungus, it is and will remain an important tool to define the diagnostic significance of positive culture isolates or results from PCR testing. However, there are very few instances where the morphological characteristics of fungi are specific. Therefore, histopathologic diagnosis should be primarily descriptive of the fungus and should include the presence or absence of tissue invasion and the host reaction to the infection. The pathology report should also include a comment stating the most frequent fungi associated with that morphology as well as other possible fungi and parasites that should be considered in the differential diagnosis. Alternate techniques have been used to determine the specific agent present in the histopathologic specimen, including immunohistochemistry, in situ hybridization, and PCR. In addition, techniques such as laser microdissection will be useful to detect the now more frequently recognized dual fungal infections and the local environment in which this phenomenon occurs.

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Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

Section: Morphologies Of Organisms In Tissues In Various Diseases Dismentioning

confidence: 99%

See 1 more Smart Citation

Histopathologic Diagnosis of Fungal Infections in the 21st Century

2011

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“…El tratamiento de la histoplasmosis en niños, según las guías del 2007 de la Infectious Diseases Society of America (13,14), se basa en la administración de dos antifúngicos, la anfotericina B (deoxicolato) y el itraconazol. En general, no se administra medicación fungicida a los pacientes con histoplasmosis pulmonar de menos de cuatro semanas de evolución, y solo se tratan aquellos que sigan sintomáticos por más tiempo y los que presenten formas diseminadas.…”

Section: Tratamientounclassified

Histoplasmosis diseminada progresiva con afectación del sistema nervioso central en un paciente inmunocompetente. Presentación de un caso y revisión de la literatura

2014

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La histoplasmosis es una afección polifacética producida por el hongo dimorfo Histoplasma capsulatum, cuyas esporas son inhaladas y llegan al pulmón, órgano primario de infección. La forma meníngea, considerada como una de las manifestaciones más graves de esta micosis, suele presentarse en individuos con alteraciones en la inmunidad celular: pacientes con síndrome de inmunodeficiencia humana adquirida, con lupus eritematoso sistémico o con trasplante de órgano sólido, así como en lactantes, debido a su inmadurez inmunológica. La forma de presentación más usual es de resolución espontánea y se observa en individuos inmunocompetentes que se han expuesto a altas concentraciones de conidias y fragmentos miceliares del hongo. En estas personas, la afección se manifiesta por trastornos pulmonares y por la posterior diseminación a otros órganos y sistemas. Se presenta un caso de histoplasmosis del sistema nervioso central en un niño inmunocompetente. Histoplasmosis of the central nervous system in an immunocompetent patientHistoplasmosis is a multifaceted condition caused by the dimorphic fungi Histoplasma capsulatum whose infective spores are inhaled and reach the lungs, the primary organ of infection. The meningeal form, considered one of the most serious manifestations of this mycosis, is usually seen in individuals with impaired cellular immunity such as patients with acquired immunodeficiency syndrome, systemic lupus erythematous or solid organ transplantation, and infants given their immunological immaturity. The most common presentation is self-limited and occurs in immunocompetent individuals who have been exposed to high concentrations of conidia and mycelia fragments of the fungi. In those people, the condition is manifested by pulmonary disorders and late dissemination to other organs and systems. We report a case of central nervous system histoplasmosis in an immunocompetent child.

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“…1,2 Varias son las formas clí-nicas de presentación, citándose dentro de éstas: la histoplasmosis pulmonar aguda, forma diseminada aguda, diseminada progresiva y diseminada crónica. 3 El primer caso de histoplasmosis en nuestro país fue descrito por el Dr. Gast Galvis en 1947. 4,5 Pocos casos han sido descritos en Colombia en la población pediátrica y menos aún en inmunocompetentes.…”

Section: Introductionunclassified

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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Histoplasmosis in children

Cited by 42 publications

References 21 publications

Histopathologic Diagnosis of Fungal Infections in the 21st Century

Histopathologic Diagnosis of Fungal Infections in the 21st Century

Histoplasmosis diseminada progresiva con afectación del sistema nervioso central en un paciente inmunocompetente. Presentación de un caso y revisión de la literatura

Histoplasmosis aguda diseminada en un niño inmunocompetente

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