Hoarseness of voice in an AIDS patient: a rare presenting feature of disseminated histoplasmosis

Sanmani, Leela; Randall, C. J.; Palfrey, Judith S.; Rowen, D

doi:10.1258/ijsa.2010.010356

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…The Itraconazole 200 mg administered twice a day for a year in mild to moderate disease, as suggested in the American guidelines (American society of infectious diseases), good treatment success rate. Surgical resection of obstructive masses can be considered and is generally safe for patients whose symptoms do not improve after one to three months of antifungal therapy 5,10 .…”

Section: Discussionmentioning

confidence: 99%

Histoplasmosis laríngea: reporte del primer caso en Colombia

Robayo

Ortiz

2014

Colomb Med

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Laryngeal histoplasmosis is a fungal infection that is frequent in Colombia. Laryngeal histoplasmosis usually occurs in immunocompromised patients through the dissemination of the fungus from the lungs to other organs. Histoplasmosis isolated laryngeal (primary) is rare. If a patient presents with a history of immunosuppression by renal transplant, primary laryngeal histoplasmosis with supraglottic granulomatous inflammation that was treated with amphotericin B and Itraconazole, with complete resolution of laryngeal lesions.

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Section: Discussionmentioning

confidence: 99%

Histoplasmosis laríngea: reporte del primer caso en Colombia

Robayo

Ortiz

2014

Colomb Med

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“…Clinical awareness is needed to suspect and diagnose the underlying genetic defects that cause invasive fungal infections. In the case of inborn errors of (Reibel et al, 1982;Samuel and Wolff, 1986;Khalil et al, 2019) Sex Male 50 (Moriones and Guerra, 2014;O'Connell et al, 2018;John et al, 2015;Samuel and Wolff, 1986;Singh et al, 2012;Tseng et al, 2005) Female 5 (Sataloff et al, 1993;Cairoli et al, 2010;Tai et al, 2010;Bahri et al, 1972;Durand et al, 2014) Basic disease Diabetes 7 (Subramaniam et al, 2005b;Phatak et al, 2006;Khalil et al, 2019;Teoh et al, 2013;Durand et al, 2014;Mackowiak, 2013;Rappo et al, 2010) HIV 5 (Sacoor, 2017;Solari et al, 2007;Troncoso et al, 2003;Sanmani et al, 2011;Pochini et al, 2007) Kidney transplantation 4 (Moriones and Guerra, 2014;Khalil et al, 2019;Jawale and Gulwani, 2017;Rappo et al, 2010 (Gerber et al, 1995) Other involved sites Lung 22 (Coiffier et al, 1998;Reibel et al, 1982;Wolf et al, 2004b;Cairoli et al, 2010;John et al, 2015;Frank et al, 2014;Pickard and Kotzen, 1973;Samuel and Wolff, 1986;Fletcher and Prussin, 1990;Klein et al, 2005;…”

Section: Discussionmentioning

confidence: 99%

Metagenomic next-generation sequencing identified Histoplasma capsulatum in the lung and epiglottis of a Chinese patient: A case report

Chen

et al. 2020

International Journal of Infectious Diseases

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Histoplasmosis is an endemic disease mainly occurring in North America and is rare in China. Confirmation of histoplasmosis should be based on a compatible clinical scenario and a positive culture or histopathology. However, there are still many cases that are misdiagnosed or missed, especially in individuals from non-endemic areas. In recent years, metagenomic next-generation sequencing (mNGS) has led to the accurate and timely diagnosis of some rare and complicated infectious diseases. We describe the case of a 27-year-old Chinese man who had chronic progressive pulmonary lesions without any symptoms for more than 1 year, until the lesions reached the epiglottis and led to progressive pharyngeal pain. There were no positive results from bronchoalveolar lavage fluid (BALF) and epiglottis tissue cultures, or from epiglottis and lung pathological examinations, but mNGS was able to identify Histoplasma capsulatum in the epiglottis tissues and BALF as the cause of the lesions. The patient was treated successfully with itraconazole.

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“… 7 Common initial manifestations are pain when swallowing, hoarseness, gingival ulceration and dysphagia. 7 , 8 Firm, painful ulcers, with elevated borders, involving the oral mucosa and larynx are characteristic. 7 , 8 …”

Section: Discussionmentioning

confidence: 99%

“… 7 , 8 Firm, painful ulcers, with elevated borders, involving the oral mucosa and larynx are characteristic. 7 , 8 …”

Section: Discussionmentioning

confidence: 99%

Disseminated cutaneous histoplasmosis with laryngeal involvement in a setting of immune reconstitution inflammatory syndrome

Sacoor

2017

South. Afr. j. HIV med.

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IntroductionHistoplasmosis is a systemic mycosis caused by the dimorphic fungus Histoplasma capsulatum. We report a case of disseminated cutaneous histoplasmosis with mucocutaneous involvement in an AIDS patient paradigmatic of the multifaceted nature of the disease, which is an expression of the immune reconstitution inflammatory syndrome (IRIS).Patient presentationA 39-year-old man presented with a three month history of asymptomatic papules and nodules with necrotic centres involving the centrofacial region. The patient was diagnosed as being HIV-positive a month earlier and was commenced on antiretroviral treatment. Two weeks after the development of skin lesions, the patient complained of a sore throat and hoarseness of his voice. A fibre-optic laryngoscopy and biopsies of the skin, larynx and liver were performed.Management and outcomeThe CD4 counts increased from 2 cells/µL to 124 cells/µL, whereas the viral load decreased from one million to less than 20 copies/mL. A fibre-optic laryngoscopy revealed a supraglottitis with ulceration on the epiglottis. Histology of the liver, larynx and sections of the skin demonstrated pandermal necrotising granulomatous inflammation. Grocott-Gomori methenamine silver and Periodic acid–Schiff (PAS) stains revealed a relative paucity of intracellular, narrow-neck budding fungal organisms. Culture findings confirmed the diagnosis of histoplasmosis. The patient was treated with intravenous amphotericin B for two weeks followed by oral itraconazole 100 mg twice a day, with an excellent response to treatment.ConclusionWe present this case to remind clinicians that disseminated histoplasmosis in AIDS patients may occur as an expression of IRIS. A sudden onset of hoarseness with cutaneous lesions in a patient with disseminated disease should alert one to possible laryngeal histoplasmosis. Prompt recognition and treatment will avert the potential fatal complications of this disease.

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Hoarseness of voice in an AIDS patient: a rare presenting feature of disseminated histoplasmosis

Cited by 7 publications

References 6 publications

Histoplasmosis laríngea: reporte del primer caso en Colombia

Histoplasmosis laríngea: reporte del primer caso en Colombia

Metagenomic next-generation sequencing identified Histoplasma capsulatum in the lung and epiglottis of a Chinese patient: A case report

Disseminated cutaneous histoplasmosis with laryngeal involvement in a setting of immune reconstitution inflammatory syndrome

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