Progressive disseminated histoplasmosis in patients with acquired immunodeficiency syndrome

Johnson, Philip C.; Khardor, Nancy; Najjar, Amjad F.; Butt, Faheem; Mansell, Peter W.A.; Sarosi, George A.

doi:10.1016/s0002-9343(88)80334-6

Cited by 213 publications

(52 citation statements)

References 37 publications

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“…The time course of the infection in these patients is measured in months, and the disease is uniformly fatal if not treated. This is in contrast to the rapidly fatal acute form of dissemination that occurs in infants and immunosuppressed patients (57,92).…”

Section: Disseminated Histoplasmosismentioning

confidence: 73%

“…Patients who are immunosuppressed and are unable to develop effective cell-mediated immunity against the organism are likely to manifest symptomatic disease during the period of acute dissemination (Table 2). This includes patients with AIDS, transplant recipients, those with hematologic malignancies, and those on corticosteroids (37,57,64,139,146). Infants, presumably because of the immaturity of their cell-mediated immune system, are a special group that develops severe life-threatening infection when exposed to H. capsulatum (35,50,92).…”

Section: Disseminated Histoplasmosismentioning

confidence: 99%

“…The child did well with treatment with nonsteroidal anti-inflammatory agents. (57,146). Patients with CD4 counts of Ͻ150 cells/l are at most risk (52,87).…”

Section: Disseminated Histoplasmosismentioning

confidence: 99%

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Histoplasmosis: a Clinical and Laboratory Update

2007

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SUMMARY Infection with Histoplasma capsulatum occurs commonly in areas in the Midwestern United States and Central America, but symptomatic disease requiring medical care is manifest in very few patients. The extent of disease depends on the number of conidia inhaled and the function of the host's cellular immune system. Pulmonary infection is the primary manifestation of histoplasmosis, varying from mild pneumonitis to severe acute respiratory distress syndrome. In those with emphysema, a chronic progressive form of histoplasmosis can ensue. Dissemination of H. capsulatum within macrophages is common and becomes symptomatic primarily in patients with defects in cellular immunity. The spectrum of disseminated infection includes acute, severe, life-threatening sepsis and chronic, slowly progressive infection. Diagnostic accuracy has improved greatly with the use of an assay for Histoplasma antigen in the urine; serology remains useful for certain forms of histoplasmosis, and culture is the ultimate confirming diagnostic test. Classically, histoplasmosis has been treated with long courses of amphotericin B. Today, amphotericin B is rarely used except for severe infection and then only for a few weeks, followed by azole therapy. Itraconazole is the azole of choice following initial amphotericin B treatment and for primary treatment of mild to moderate histoplasmosis.

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Section: Disseminated Histoplasmosismentioning

confidence: 73%

Section: Disseminated Histoplasmosismentioning

confidence: 99%

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Histoplasmosis: a Clinical and Laboratory Update

2007

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“…The disseminated form of the disease usually occurs in immunocompromised individuals such as those with acquired immune-deficiency syndrome (AIDS), transplant recipients, those with haematological malignancies, infants and those on corticosteroids, and it is caused by defective cell mediated immunity in these individuals 6 . It is becoming a common opportunistic infection among individuals with AIDS living in endemic areas 7,8,9 . On the other hand, chronic progressive disseminated histoplasmosis is a term used to describe the slowly progressive and generally fatal infection due to H. capsulatum that occurs mostly in older adults who are not overtly immunosuppressed.…”

Section: Introductionmentioning

confidence: 99%

Disseminated Histoplasmosis in a 13-year-old girl: A case report

Ubesie¹,

Okafo²,

Ibeziako³

et al. 2013

Afr H. Sci.

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Background: Disseminated histoplasmosis is a rare fungal infection and most documented cases are in immunecompromised individuals such as those with acquired immuno-deficiency syndrome. Objective: To describe a case of disseminated histoplasmosis in an adolescent girl. Method: We report a case of disseminated histoplasmosis in a 13-year-old adolescent girl. She was admitted for 16 days because of neck masses of 3 years duration, generalized body swelling of 3 months and reduction in urinary output of 2 months. She tested negative for human immunodeficiency virus antibodies. Result: An autopsy was performed because a definitive diagnosis could not be made while the patient was still alive. The autopsy revealed central caseating areas in the lymph nodes and membranoproliferative glomerulonephritis. The periodic acid-Schiff staining technique for tissues showed viable yeast cells suggestive of histoplasmosis. Zeihl-Neelsen's staining for mycobacteria tuberculosis was negative. Conclusion: Undiagnosed case of disseminated histoplasmosis while the patient was alive is being reported in a 13-yearold girl. Disseminated histoplasmosis should be considered as a differential diagnosis of childhood chronic infections and malignancies as in Nigeria.

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“…[11][12][13] Patients with CD4 counts of less than 150 cells/ µl are at increased risk. [14][15][16] Mucous membrane lesions are seen in disseminated histoplasmosis.…”

mentioning

confidence: 99%

An Unusual Penetrating Neck Trauma In Zone III

2007

IJTCVS

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Progressive disseminated histoplasmosis in patients with acquired immunodeficiency syndrome

Cited by 213 publications

References 37 publications

Histoplasmosis: a Clinical and Laboratory Update

Histoplasmosis: a Clinical and Laboratory Update

Disseminated Histoplasmosis in a 13-year-old girl: A case report

An Unusual Penetrating Neck Trauma In Zone III

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