Primary Cutaneous Histoplasmosis

Localized tenosynovitis caused by Histoplasma capsulatum: Case report and review of the literature

“…If a cat had been in contact with contaminated soil and immediately scratched our patient, it could have inoculated the fungus in her finger. Cases of primary extrapulmonary infection have been described but they are exceptional and difficult to prove (3,4). The criteria necessary to establish a diagnosis of primary local infection with a fungus capable of causing pulmonary mycosis were described in the early 1950s (5) and include the following: history of traumatic inoculation, with subsequent development of a chancriform lesion; lymphangitis and regional lymphadenopathy; evidence that the wound was contaminated with the causative fungus; no history or clinical or laboratory evidence of previous pulmonary or systemic mycosis; and confirmation of the skin test result from negative to positive.…”

A Case of Primary Cutaneous Histoplasmosis in a Patient with Diabetes and Multi‐Infarct Dementia

“…They were described as pustules, nodules, ulcers, or cellulitis‐like plaques (15). Although it is considered classically to be a single lesion often of chancriform type (9), PCH was also described to present as multiple plaques especially in immunosuppressed individuals (17) or after heavy inoculation in the time of initial exposure (14). Primary mucocutaneous histoplasmosis has also rarely been described in HIV disease where it presented as multiple “keratoacanthoma‐like” nodules on the neck (17) or as a solitary plaque on the oral mucosa (20).…”

Primary Cutaneous Histoplasmosis in Immunosuppressed Patient

“…However, some investigators have suggested that skin lesions are never primary but are instead mani¬ festations of disseminated histoplas¬ mosis.89 Tesh and Schneidau5 used the following criteria to establish the diagnosis of primary cutaneous histo¬ plasmosis: (1) history of traumatic inoculation with subsequent develop¬ ment of a chancriform lesion within three to four weeks at the site of trauma, (2) evidence that the wound was contaminated with the causative fungus, (3) development of lymphan¬ gitis and regional lymphadenopathy, (4) no history, clinical, or laboratory evidence of previous pulmonary or systemic infection, and (5) conversion of the histoplasmin skin test from negative to positive and a rising serological titer.…”