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diagnosis and treatment histoplasmosis

Michael J Maze, Quique Bassat, Nicholas A Feasey, Inácio Mandomando, Patrick Musicha, John A Crump
BACKGROUND: Fever is among the most common symptoms of people living in Africa, and clinicians are challenged by the similar clinical features of a wide spectrum of potential aetiologies. AIM: To summarise recent studies of fever aetiology in sub-Saharan Africa focusing on causes other than malaria. SOURCES: A narrative literature review by searching the MEDLINE database, and recent conference abstracts. CONTENT: Studies of multiple potential causes of fever are scarce, and for many participants the infecting organism remains unidentified, or multiple co-infecting microorganisms are identified, and establishing causation is challenging...
February 15, 2018: Clinical Microbiology and Infection
Nisha Loganantharaj, Brianna Oliver, Taylor Smith, Rachna Jetly, Lee Engel, Shane Sanne
A 46-year-old Dominican man, known to have HIV, presented with constitutional symptoms of two week's duration. The patient was found to have cytopenias, significantly elevated ferritin level and lymphadenopathy. Biopsies and laboratory studies met the criteria for hemophagocytic lymphohistiocytosis (HLH). A concomitant diagnosis of histoplasmosis was confirmed as the trigger for HLH and treatment resulted in clinical improvement and resolution of symptoms.
January 1, 2018: International Journal of STD & AIDS
L V Gómez-Santana, A C Torre, B A Hernández, V I Volonteri, B Laura, R Luis-Galimberti
Histoplasmosis is a systemic mycosis caused by the dimorphous fungus Histoplasma capsulatum (H. capsulatum). The fungus enters the body through the respiratory tract in the form of microconidia, which are transformed into intracellular yeast-like structures in the lungs before disseminating hematogenously. Primary infection is usually asymptomatic and self-resolving. Some patients develop severe disease with acute or chronic respiratory involvement. Immunosuppressed patients, mainly those with altered cellular immunity, may have disseminated disease with variable mucocutaneous involvement characterized by papules, nodules, gummas, or ulcers with a granulomatous base...
February 8, 2018: Actas Dermo-sifiliográficas
Caroline T Simon, Carlos A Murga-Zamalloa, Michael A Bachman, Lindsay A Petty, Sarah M Choi
Disseminated histoplasmosis and hemophagocytic lymphohistiocytosis show overlapping features, which require careful contextual interpretation. Histopathologic evaluation can potentially rapidly identify cases of possible histoplasmosis. A high index of clinical suspicion, particularly in endemic areas and in a setting of immunosuppression, is critical to appropriate diagnosis and treatment.
January 2018: Clinical Case Reports
Rita O Oladele, Olusola O Ayanlowo, Malcolm D Richardson, David W Denning
Histoplasmosis in Africa has markedly increased since the advent of the HIV/AIDS epidemic but is under-recognised. Pulmonary histoplasmosis may be misdiagnosed as tuberculosis (TB). In the last six decades (1952-2017), 470 cases of histoplasmosis have been reported. HIV-infected patients accounted for 38% (178) of the cases. West Africa had the highest number of recorded cases with 179; the majority (162 cases) were caused by Histoplasma capsulatum var. dubuosii (Hcd). From the Southern African region, 150 cases have been reported, and the majority (119) were caused by H...
January 2018: PLoS Neglected Tropical Diseases
Katia Cristina Dantas, Roseli Santos de Freitas, Marcos Vinicius da Silva, Paulo Ricardo Criado, Olinda do Carmo Luiz, Adriana Pardini Vicentini
BACKGROUND: Although early and rapid detection of histoplasmosis is essential to prevent morbidity and mortality, few diagnostic tools are available in resource-limited areas, especially where it is endemic and HIV/AIDS is also epidemic. Thus, we compared conventional and molecular methods to detect Histoplasma capsulatum in sera and blood from HIV/AIDS patients. METHODOLOGY: We collected a total of 40 samples from control volunteers and patients suspected of histoplasmosis, some of whom were also infected with other pathogens...
2018: PloS One
Tummidi Santosh, Kanchan Kothari, Shruti S Singhal, Vyoma V Shah, Roshni Patil
BACKGROUND: Histoplasma capsulatum is a dimorphic fungus predominately found in soils enriched with bird and bat excreta. Although several cases of histoplasmosis have been reported in India, diagnosis using cytology has been done in very few cases. CASE PRESENTATION: We report here a case of disseminated histoplasmosis in a 46-year-old Indian man. CONCLUSION: Skin scrape cytology is a simple, safe, and rapid technique to establish the initial diagnosis, thus promoting early treatment and favorable outcome, in cutaneous fungal infections...
January 12, 2018: Journal of Medical Case Reports
Allison G Wilson, Kate S KuKanich, Andrew S Hanzlicek, Mark E Payton
OBJECTIVE To determine the clinical manifestations of histoplasmosis in a large sample of dogs, compare outcomes achieved with fluconazole versus itraconazole, and identify variables available at the time of diagnosis with prognostic value. DESIGN Retrospective case series with nested cohort study. ANIMALS 79 dogs with confirmed histoplasmosis evaluated at 2 veterinary teaching hospitals from 1999 through 2015. PROCEDURES Medical records were reviewed and data extracted regarding clinical signs at evaluation, physical examination findings, clinical laboratory values, other diagnostic test results, treatments, and outcomes...
January 15, 2018: Journal of the American Veterinary Medical Association
Laura Washburn, N Thao Galván, Sadhna Dhingra, Abbas Rana, John A Goss
Histoplasmosis is an endemic mycosis in the Ohio and Mississippi River valleys and can cause disseminated infection in immunocompromised hosts. Disseminated histoplasmosis is often respiratory in nature and most cases in transplant patients occur within 2 years post-transplantation. A 32-year-old male on mycophenolate and tacrolimus who underwent an orthotopic liver transplantation 10 years prior presented with generalized body aches, fevers, mild congestion, dysuria and elevated transaminases. Liver biopsy revealed epithelioid granulomas with narrow-based budding yeast, suggesting histoplasma...
December 2017: Journal of Surgical Case Reports
Michael Stephen Pohlen, Jonathan Sunwei Lin, Kevin Yuqi Wang, Mohammad Ghasemi-Rad, Christie M Lincoln
A 28-year-old man recently diagnosed with HIV (CD4 19 cells/mm3 , viral load 3.6 million copies/mL, not on highly active antiretroviral therapy on initial diagnosis at outside hospital), disseminated histoplasmosis, shingles and syphilis presented with paraplegia developing over 3 days. Spine MRI demonstrated a longitudinally extensive cord lesion extending from C3 to the tip of the conus. Brain MRI was consistent with meningoencephalitis. Cerebrospinal fluid findings were notable for positive varicella zoster virus (VZV) and cytomegalovirus (CMV) PCRs as well as a Venereal Disease Research Laboratory titre of 1:2...
December 2, 2017: BMJ Case Reports
Massimo Galli, Spinello Antinori, Fabiola Atzeni, Luca Meroni, Agostino Riva, Carlo Scirè, Fulvio Adorni, Luca Quartuccio, Marco Sebastiani, Paolo Airò, Laura Bazzichi, Francesco Cristini, Valerio Del Bono, Andreina Manfredi, Ombretta Viapiana, Francesco De Rosa, Ennio Favalli, Enzo Petrelli, Carlo Salvarani, Marcello Govoni, Silvia Corcione, Rossana Scrivo, Loredana Sarmati, Adriano Lazzarin, Walter Grassi, Claudio Mastroianni, Giovanni Battista Gaeta, Gianfranco Ferraccioli, Maurizio Cutolo, Salvatore De Vita, Giovanni Lapadula, Marco Matucci-Cerinic, Orlando Armignacco, Piercarlo Sarzi-Puttini
Often life-threatening pulmonary fungal infections (PFIs) can occur in patients with rheumatoid arthritis (RA) receiving disease-modifying anti-rheumatic drugs (DMARDs). Most of the data concerning PFIs in RA patients come from case reports and retrospective case series. Of the ve most widely described PFIs, Pneumocystis jirovecii pneumonia (PJP) has rarely been seen outside Japan, pulmonary cryptococcosis has been diagnosed in only a small number of patients worldwide, pulmonary coccidioidomycosis has almost only been observed in endemic areas, the limited number of cases of pulmonary histoplasmosis have mainly occurred in the USA, and the rare cases of invasive pulmonary aspergillosis have only been encountered in leukopenic patients...
November 2017: Clinical and Experimental Rheumatology
Giancarlo Pérez-Lazo, Julio Maquera-Afaray, Christian R Mejia, Raúl Castillo
BACKGROUND: Histoplasmosis is an endemic fungal infection in Peru and HIV coinfection leads to difficult diagnoses and high associated mortality. AIM: To describe clinical, epidemiological and clinical outcomes in patients with HIV infection with diagnosis of disseminated histoplasmosis (DH) at Guillermo Almenara Irigoyen National Hospital, Lima, Peru. METHODS: Retrospective, descriptive study; information was obtained from the computer registry of patients with HIV infection diagnosed with DH, during the period 1996-2014...
August 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Ilan S Schwartz, Chris Kenyon, Rannakoe Lehloenya, Saskya Claasens, Zandile Spengane, Hans Prozesky, Rosie Burton, Arifa Parker, Sean Wasserman, Graeme Meintjes, Marc Mendelson, Jantjie Taljaard, Johann W Schneider, Natalie Beylis, Bonnie Maloba, Nelesh P Govender, Robert Colebunders, Sipho Dlamini
Background: Skin lesions are common in advanced HIV infection and are sometimes caused by serious diseases like systemic mycoses (SM). AIDS-related SM endemic to Western Cape, South Africa, include emergomycosis (formerly disseminated emmonsiosis), histoplasmosis, and sporotrichosis. We previously reported that 95% of patients with AIDS-related emergomycosis had skin lesions, although these were frequently overlooked or misdiagnosed clinically. Prospective studies are needed to characterize skin lesions of SM in South Africa and to help distinguish these from common HIV-related dermatoses...
2017: Open Forum Infectious Diseases
Brendon M Esquibel, Christine J Waller, William A Agger
Patients are commonly referred to general surgery clinics for evaluation of soft-tissue masses of the trunk and extremities. The primary goal of surgical referral is to confirm the presence of a mass, to assess the need for additional imaging and/or testing, and to gauge amenability to surgical biopsy, whether incisional or excisional. This is a case of a 67-year-old woman who was referred to surgery clinic for a small soft-tissue mass near her left elbow that had increased in size and pain over the past year...
2017: Case Reports in Infectious Diseases
Karen C Bloch, Thein Myint, Luke Raymond-Guillen, Chadi A Hage, Thomas E Davis, Patty W Wright, Felicia C Chow, Laila Woc-Colburn, Raed N Khairy, Alan C Street, Tomotaka Yamamoto, Amanda Albers, L Joseph Wheat
Background: Central nervous system (CNS) histoplasmosis is a life-threatening condition and represents a diagnostic and therapeutic challenge. Isolation of H. capsulatum from cerebrospinal fluid (CSF) or brain tissue is diagnostic; however, culture is insensitive and slow growth may result in significant treatment delay. We performed a retrospective multicenter study to evaluate the sensitivity and specificity of a new anti-Histoplasma antibody enzyme immunoassay (EIA) for the detection of IgG and IgM antibody in the CSF for diagnosis of CNS histoplasmosis, the primary objective of the study...
August 20, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Vikram K Mahajan, Rashmi Kaul Raina, Suman Singh, Rattan Sagar Rashpa, Anuradha Sood, Pushpinder S Chauhan, Karaninder S Mehta, Ritu Rawat, Vikas Sharma
We describe four cases of histoplasmosis indigenous to Himachal Pradesh (India) that will be of considerable public health interest. A 48-year-old human immunodeficiency virus (HIV)-negative man with cervical and mediastinal lymphadenopathy, hepatosplenomegaly, adrenal mass, and bone marrow involvement was treated as disseminated tuberculosis without benefit. Progressive disseminated histoplasmosis was diagnosed from the fungus in smears from adrenal mass. Another 37-year-old HIV-positive man was on treatment of suspected pulmonary tuberculosis...
December 2017: American Journal of Tropical Medicine and Hygiene
Séverine Evrard, Philippe Caprasse, Pierre Gavage, Myriam Vasbien, Jean Radermacher, Marie-Pierre Hayette, Rosalie Sacheli, Marjan Van Esbroeck, Lieselotte Cnops, Eric Firre, Laurent Médart, Filip Moerman, Jean-Marc Minon
Case report We report the case of a young Cameroonian woman who presented with cough, hyperthermia, weight loss, pancytopenia, and hepatosplenomegaly. A positive HIV serology was discovered and a chest radiography revealed a 'miliary pattern'. Bone marrow aspiration pointed out yeast inclusions within macrophages. Given the morphological aspect, the clinical presentation and immunosuppression, histoplasmosis was retained as a working hypothesis. Antiretroviral and amphotericin B treatments were promptly initiated...
September 28, 2017: Acta Clinica Belgica
Daniel B Chastain, Andrés F Henao-Martínez, Carlos Franco-Paredes
PURPOSE OF REVIEW: The goal of this review is to provide an update on the epidemiology, diagnosis, and treatment of opportunistic fungal infections in patients with human immunodeficiency virus (HIV) infection including Cryptococcus spp., Histoplasma spp., Coccidioides spp., and Talaromyces marneffei, formerly Penicillium marneffei. RECENT FINDINGS: In many settings, despite increasing roll out of antiretroviral therapy (ART), opportunistic invasive mycoses produce a substantial burden of disease...
August 22, 2017: Current Infectious Disease Reports
P M Jawale, H V Gulwani
Histoplasmosis has variable clinical presentation that mimics various benign and malignant lesions. It is more often associated with pulmonary lesions and disseminated form of disease. Herein, we report a rare case of localized laryngeal histoplasmosis in a 62-year-old Indian man who presented with hoarseness of voice and dysphagia. Post-renal transplant, he was on immunosuppressive drugs for last three years. Laryngoscopy revealed an ulceroproliferative growth at base of tongue, which was extending upto the pyriform fossa...
December 2017: Journal de Mycologie Médicale
Zhe Wu, Hannah Jarvis, Luke S Howard, Corrina Wright, Onn Min Kon
Fibrosing mediastinitis (FM) is a rare disease where there is thickening of the fibrous tissue in the mediastinum. While histoplasmosis is the the most common recognised cause, the link with tuberculosis (TB) has been rarely documented. We review the link between TB and FM, and describe a case of probable TB-related FM.Our case is of a 74-year-old man who presented with breathlessness 3 years after fully treated TB. Scans revealed a calcified soft tissue mass within the mediastinum, and a diagnosis of fibrosing mediastinitis resulting in pulmonary hypertension was made...
2017: BMJ Open Respiratory Research
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