Subacute Histoplasmosis with Focal Involvement of the Epiglottis: Importance of Differential Diagnosis

Ahumada, Fernando Valenzuela; Perez, D. Martinez; Górgolas, Miguel; Álvarez, Beatriz; Rios, Adson Sales do Nascimento; Sánchez, A.; Villacampa, J M

doi:10.1155/2014/235975

Cited by 9 publications

(10 citation statements)

References 12 publications

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“…Primary laryngeal histoplasmosis is very rare with approximately a hundred cases described in the literature; most cases being reported in patients with uncontrolled HIV. Only four cases of laryngeal histoplasmosis have been previously described in solid organ transplant recipients; three were renal transplant recipients and one was a liver transplant recipient . Demographics, clinical characteristics, treatment, and outcome of the patients are listed in table .…”

Section: Discussionmentioning

confidence: 99%

Laryngeal histoplasmosis in a kidney transplant recipient

Khalil

Challener

AbuSaleh

et al. 2019

Transplant Infectious Dis

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Histoplasma capsulatum is an endemic fungus that most oftenly causes a self‐limiting illness but can result in severe infections in immunocompromised patients including pulmonary or extra‐pulmonary disease. Rarely it can also cause a chronic progressive infection of the larynx. Herein, we report a case of laryngeal histoplasmosis in a kidney transplant patient who presented with progressive symptoms of several weeks of hoarseness, dysphagia and odynophagia. Laryngoscopic examination revealed thick plaques in the oropharynx with surrounding hyper‐erythema and histopathology showed numerous intracellular yeasts forms consistent with H capsulatum. Patient was initiated on treatment with itraconazole. Infection of the larynx due to H capsulatum is highly uncommon and therefore can result in an inappropriate or delayed diagnosis. A review of literature showed four previously reported cases of laryngeal histoplasmosis in patients with solid organ transplant. This is the first case series of laryngeal histoplasmosis in transplant recipients.

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Section: Discussionmentioning

confidence: 99%

Laryngeal histoplasmosis in a kidney transplant recipient

Khalil

Challener

AbuSaleh

et al. 2019

Transplant Infectious Dis

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“…A large proportion of those infected remain clinically asymptomatic, a finding that is related to both the degree of inoculating dose and state of immunocompetency. [ [1] , [2] , [4] , [6] ]. Cellular immunity is essential in clearing initial infection, but organisms may not be eradicated completely and reactivation of disease is possible [ [3] , [5] ].…”

Section: Discussionmentioning

confidence: 99%

Oropharyngeal histoplasmosis: The diagnosis lies in the biopsy

Miranda

Jaker

Fitzhugh-Kull

et al. 2018

IDCases

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Histoplasma capsulatum, a dimorphic fungus found world-wide, is endemic to regions of the Mississippi and Ohio River valleys and portions of Central and South America. Initial infection can present with acute pulmonary symptoms or remain clinically asymptomatic, with disease course generally guided by degree of inoculum and underlying immunosuppression. A chronic, progressive course of weight loss, oral ulceration, and fatigue has been associated with elderly males. We present a 79-year-old man with a chronic, progressive course of oral lesions, odynophagia, and weight loss who was found to have histoplasmosis on oral biopsy performed for suspicions of oropharyngeal squamous cell carcinoma. Histoplasma urine antigen, serum complement fixation antibody titers, and fungal tissues were all negative despite validated sensitivities in the >90% range. Our case report highlights the critical role of tissue biopsy in establishing a diagnosis of oropharyngeal histoplasmosis.

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“…capsulatum is a dimorphic fungus with a worldwide distribution, endemic in North America-with high prevalence in the soil from the midwestern and southern regions of the US [138] and areas within Latin America, and is associated with outbreaks in particular regions of Africa and Asia [139]. Despite the cosmopolitan characteristic, the exact frequency of the mycosis is still unclear as only few laboratories in endemic countries are prepared to effectively establish the diagnosis, particularly since histoplasmosis may simulate prevalent diseases such as cancer or tuberculosis [140,141].…”

Section: Histoplasma Sppmentioning

confidence: 99%

Immunotherapy against Systemic Fungal Infections Based on Monoclonal Antibodies

Boniche

Rossi

Kischkel

et al. 2020

JoF

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The increasing incidence in systemic fungal infections in humans has increased focus for the development of fungal vaccines and use of monoclonal antibodies. Invasive mycoses are generally difficult to treat, as most occur in vulnerable individuals, with compromised innate and adaptive immune responses. Mortality rates in the setting of our current antifungal drugs remain excessively high. Moreover, systemic mycoses require prolonged durations of antifungal treatment and side effects frequently occur, particularly drug-induced liver and/or kidney injury. The use of monoclonal antibodies with or without concomitant administration of antifungal drugs emerges as a potentially efficient treatment modality to improve outcomes and reduce chemotherapy toxicities. In this review, we focus on the use of monoclonal antibodies with experimental evidence on the reduction of fungal burden and prolongation of survival in in vivo disease models. Presently, there are no licensed monoclonal antibodies for use in the treatment of systemic mycoses, although the potential of such a vaccine is very high as indicated by the substantial promising results from several experimental models.

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Subacute Histoplasmosis with Focal Involvement of the Epiglottis: Importance of Differential Diagnosis

Cited by 9 publications

References 12 publications

Laryngeal histoplasmosis in a kidney transplant recipient

Laryngeal histoplasmosis in a kidney transplant recipient

Oropharyngeal histoplasmosis: The diagnosis lies in the biopsy

Immunotherapy against Systemic Fungal Infections Based on Monoclonal Antibodies

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