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diagnosis and treatment histoplasmosis

Bernhard Doleschal, Therese Rödhammer, Oleksiy Tsybrovskyy, Karl J Aichberger, Franz Lang
Histoplasmosis is well characterized as an endemic fungal disease restricted to certain areas of the USA. In Middle Europe, most patients present with acute pulmonary symptoms after travelling to endemic areas. Here, we want to illustrate the case of a 67-year-old man who presented with persistent oral ulcers, hoarseness, dysphagia, diarrhea, and weight loss to our Department of Otorhinolaryngology in December 2014. He was a retired construction worker and had a history of soil-disruptive activities in Africa and Middle and South America during employment...
September 2016: Case Reports in Gastroenterology
Cui Zhu, Ge Wang, Qiong Chen, Bixiu He, Lijing Wang
In the present study, the case of a 54-year-old male patient diagnosed with pulmonary histoplasmosis is reported, with the aim to increase the understanding of the disease characteristics and thereby facilitate the diagnosis and treatment of pulmonary histoplasmosis. Clinical manifestations, diagnosis, treatment and clinical outcomes of the present case of pulmonary histoplasmosis were described. In addition, 76 histoplasmosis patients with complete clinical data were reviewed by searching the literature for relevant studies published during 1990 and 2015...
November 2016: Experimental and Therapeutic Medicine
Prajwala Gupta, Minakshi Bhardwaj
Disseminated histoplasmosis is caused by the dimorphic fungus Histoplasma capsulatum (H. capsulatum). The early clinical manifestations are nonspecific, often lead to diagnostic difficulty, and is misdiagnosed as tuberculosis and seen usually in immunosuppressed states. Fine needle aspiration cytology (FNAC) is a simple, safe, and quick technique to establish the initial diagnosis of H. capsulatum, thereby prompting early treatment. The skin involvement is rare in disseminated disease and we describe a case of disseminated histoplasmosis in an immunocompetent patient with unusual molluscum contagiosum like umbilicated skin lesions and FNAC of the cervical lymph node was the only tool for rapid and early confirmatory diagnosis...
July 2016: Journal of Cytology
Prasan K Panda, Siddharth Jain, Rita Sood, Rajni Yadav, Naval K Vikram
Histoplasmosis is caused by a dimorphic fungus Histoplasma capsulatum in endemic areas, mainly America, Africa, and Asia. In India, it is being reported from most states; however, it is endemic along the Ganges belt. We report a case of an apparently immunocompetent male who presented with 3-month history of fever, cough, and weight loss with recent onset odynophagia and had hepatosplenomegaly and mucocutaneous lesions over the face. The differential diagnosis of leishmaniasis, tuberculosis, leprosy, fungal infection, lymphoproliferative malignancy, and other granulomatous disorders was considered, but he succumbed to his illness...
2016: Case Reports in Infectious Diseases
Andrej Spec, Christopher R Barrios, Usama Ahmad, Laurie A Proia
Severe pulmonary or disseminated histoplasmosis often necessitates presumptive antifungal treatment while awaiting definitive diagnosis. Histoplasma antigen assays have improved sensitivity but results may lag up to 7 days. In order to increase diagnostic certainty, "soft clues" may be looked for in laboratory and radiologic data, such as elevated alkaline phosphatase or ferritin levels and findings of mediastinal adenopathy or hepatosplenomegaly. To determine if elevated aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio is specific to histoplasmosis or a non-specific marker for disseminated fungal infection or sepsis in general, we retrospectively examined records of all patients diagnosed with an endemic fungal infection (EFI) at Rush University Medical Center from January of 1997 to October of 2012, and a cohort of septic patients with elevated liver enzymes...
October 14, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Benjamin E Bergstrom, Jean Stiles, Wendy M Townsend
OBJECTIVE: To determine the most common etiologies of panuveitis in a group of dogs, patient response to therapy, and visual outcome. DESIGN: Retrospective study. MATERIALS AND METHODS: Medical records of 55 dogs diagnosed with panuveitis at the Purdue University Veterinary Teaching Hospital between December 2000 and December 2015 were reviewed. Data collected included signalment, season of diagnosis, descriptions of ocular lesions, diagnostic testing, treatment protocols, etiologic diagnoses (when determined), and visual outcome...
October 12, 2016: Veterinary Ophthalmology
Thaísa C Silva, Carolina M Treméa, Ana Laura S A Zara, Ana Flávia Mendonça, Cássia S M Godoy, Carolina R Costa, Lúcia K H Souza, Maria R R Silva
Histoplasmosis is a systemic mycosis that is considered an important public health problem. In this work, we performed a descriptive, observational, cross-sectional and retrospective study with a secondary data analysis of medical records from 2000 to 2012 at a tertiary hospital. The study sample consisted of 275 patients with laboratory-confirmed Disseminated Histoplasmosis (DH)/AIDS. The results showed that the prevalence of DH associated with AIDS was 4.4%. The majority of patients were young adult men with fever in 84...
January 2017: Mycoses
Neetu Bhari, Piyush Pahadiya, Sudheer Arava, Somesh Gupta
In patients with acquired immunodeficiency syndrome (AIDS), advanced immunosuppression is associated with atypical presentation of dermatological conditions. Our patient presented with a single crusted plaque over the lower lip and large tender cervical lymphadenopathy. The enzyme-linked immunosorbent assay for human immunodeficiency virus was found to be positive, and his CD4+ lymphocyte cell count was 4 cells/mm(3) The presence of multiple histoplasma spores in the biopsies from the crusted plaque over lip and cervical lymph node helped in the confirmation of the diagnosis of histoplasmosis, and the patient showed significant improvement within two months of treatment with conventional injection amphotericin B initially followed by oral itraconazole...
August 17, 2016: International Journal of STD & AIDS
Kathryn M Smith, Ann R Strom, Margi A Gilmour, Elise LaDouceur, Christopher M Reilly, Barbara A Byrne, Verena K Affolter, Jane E Sykes, David J Maggs
CASE SERIES SUMMARY: This case series describes the clinical utility of antigen testing for the diagnosis of feline ocular histoplasmosis. Four cats with suspected (n = 2) or confirmed (n = 2) ocular histoplasmosis are described: three from Oklahoma and one from California. In one case, serial urine antigen tests, as well as a serum antigen test for Histoplasma capsulatum, were negative; however, light microscopy identified microorganisms consistent with H capsulatum in ocular tissues at necropsy...
August 15, 2016: Journal of Feline Medicine and Surgery
J E Carrasco-Zuber, C Navarrete-Dechent, A Bonifaz, F Fich, V Vial-Letelier, D Berroeta-Mauriziano
In the second part of this review on the deep mycoses, we describe the main systemic mycoses-paracoccidioidomycosis, coccidioidomycosis, histoplasmosis, mucormycosis, and cryptococcosis-and their cutaneous manifestations. Skin lesions are only occasionally seen in deep systemic mycoses either directly, when the skin is the route of entry for the fungus, or indirectly, when the infection has spread from a deeper focus. These cutaneous signs are often the only clue to the presence of a potentially fatal infection...
August 4, 2016: Actas Dermo-sifiliográficas
Li Zhou, Songqing Fan, Qingchun Liang, Yating Peng, Dandan Zong, Ruoyun Ouyang
To explore the clinical characteristics, imaging manifestation, diagnosis and treatment for histoplasmosis and to improve therapeutic level, we retrospectively analyzed the clinical data of 8 patients with biopsy-confirmed histoplasmosis from 2004 to 2014 in the Second Xiangya Hospital of Central South University and reviewed relevant literatures. The main clinical symptoms of histoplasmosis included fever, cough, expectoration, chest pain, blood-stained sputum, lymphadenectasis, etc. The major lung imaging features were mass, node or pneumonia-like performance...
June 28, 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Marco Antonio Bruno, Matías Parodi, Ignacio Olmedo, Héctor Picón Molina, Rafael Palencia, Alejandro Doniquian
INTRODUCTION: The Cytomegalovirus (CMV) is a virus that affects the host and remains latent. When cellular immunity is suppressed, the virus is reactivated and can cause an asymptomatic or devastating infection in immunosuppressed patients. On the other hand, Histoplasmosis is typically a respiratory condition. However, in immunosuppressed patients, it may be found in unusual locations, as in the case of an intestinal condition. In some cases, this can be fatal. Small intestine CMV location is extremely rare...
2016: International Journal of Surgery Case Reports
Jennifer Hess, Andrew Fondell, Nicholas Fustino, Jeff Malik, Christopher Rokes
Histoplasmosis is an endemic fungus in several regions of the United States. The diagnosis and treatment of this infection can be challenging in pediatric oncology patients. We present 5 patients diagnosed with histoplasmosis while receiving treatment at a midsize pediatric oncology center in Iowa. Two cases occurred in patients with acute lymphoblastic leukemia and 3 cases in patients with solid tumors. All patients were treated with antifungal therapy and demonstrated excellent clinical response. Histoplasmosis should be considered as a potential cause of nonspecific febrile illness, pulmonary masses, and bone marrow suppression in immunocompromised patients in endemic regions...
June 1, 2016: Journal of Pediatric Hematology/oncology
Ignacio Esteban, Pablo Minces, Analía M De Cristofano, Ricardo Negroni
Neurohistoplasmosis is a rare disease, most prevalent in immunosuppressed patients, secondary to disseminated disease with a high mortality rate when diagnosis and treatment are delayed. We report a previously healthy 12 year old girl, from a bat infested region of Tucuman Province, Argentine Republic, who developed meningoencephalitis due to Histoplasma capsulatum. Eighteen months prior to admission the patient started with headaches and intermittent fever. The images of the central nervous system showed meningoencephalitis suggestive of tuberculosis...
June 1, 2016: Archivos Argentinos de Pediatría
A S Hanzlicek, J H Meinkoth, J S Renschler, C Goad, L J Wheat
BACKGROUND: Treatment monitoring is subjective and disease relapse is common in cats with histoplasmosis. The Histoplasma antigen enzyme immunoassay (EIA) is a noninvasive test used for determining disease remission and detecting disease relapse in humans with histoplasmosis. The utility of the antigen EIA for these purposes in cats remains unknown. HYPOTHESIS/OBJECTIVES: Those Histoplasma antigen concentrations in urine and serum would decline with antifungal treatment and that antigen elimination would be an indicator of clinical remission in cats with histoplasmosis treated with antifungal treatment...
July 2016: Journal of Veterinary Internal Medicine
Smeeta Gajendra, Rashi Sharma, Shalini Goel, Ruchika Goel, Lipika Lipi, Hemanti Sarin, Mridula Guleria, Ritesh Sachdev
OBJECTIVE: Histoplasmosis is an infectious disease caused by the dimorphic fungus Histoplasma capsulatum, endemic in central and eastern states of United States, South America and Africa. India is considered to be non-endemic area for histoplasmosis. Disseminated histoplasmosis may affect almost all systems. Disseminated histoplasmosis with asymptomatic adrenal involvement has been described in immunocompromised patients; whereas isolated adrenal involvement with adrenal insufficiency as the presenting manifestation of the disease is rare...
2016: Türk Patoloji Dergisi
Sayaka Asahata-Tago, Yuji Hirai, Yusuke Ainoda, Takahiro Fujita, Yasunori Muraosa, Katsuhiko Kamei, Megumi Wakayama, Kazutoshi Shibuya, Ken Kikuchi
We report herein on the case of a 33-year-old Japanese man in whom an abnormal shadow was detected on chest radiography during a medical checkup after a 1-year-stay in Mexico. Chest computed tomography showed a nodule in the left lower lobe adjacent to the visceral pleura. Histopathologic examination of a thoracoscopic partial pulmonary resection specimen showed coagulation necrosis with a number of yeast-like forms on Grocott staining. In addition, serum anti-Histoplasma antibody positivity was detected with an enzyme-linked immunosorbent assay, and Histoplasma-specific nested real-time polymerase chain reaction results were positive in the pulmonary region...
January 2016: Kansenshōgaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
Harita Nyalakonda, Marisol Albuerne, Lia Patricia Suazo Hernandez, Juan C Sarria
BACKGROUND: Involvement of the central nervous system (CNS) by Histoplasma capsulatum in AIDS is uncommon and not easily recognized. MATERIALS AND METHODS: CNS histoplasmosis cases from our institution were identified by a retrospective chart review from 2004-2014. A thorough literature search was performed for additional cases and their characteristics were compared. Clinical findings, treatment and outcomes are discussed. RESULTS: A total of 5 cases from our institution were identified...
February 2016: American Journal of the Medical Sciences
Lawrence J Wheat, Marwan M Azar, Nathan C Bahr, Andrej Spec, Ryan F Relich, Chadi Hage
Although histoplasmosis is highly endemic in certain regions of the Americas, disease may be seen globally and should not be overlooked in patients with unexplained pulmonary or systemic illnesses. Most patients exhibit pulmonary signs and symptoms, accompanied by radiographic abnormalities, which often are mistaken for community-acquired pneumonia caused by bacterial or viral agents. Once a diagnosis is considered, a panel of mycologic and non-culture-based assays is adequate to establish a diagnosis in a few days to a week in most patients...
March 2016: Infectious Disease Clinics of North America
Fernando Almeida-Silva, Lisandra Serra Damasceno, Maria Jose Buitrago Serna, Clara Valero, Leonardo Pereira Quintella, Rodrigo Almeida-Paes, Mauro de Medeiros Muniz, Rosely Maria Zancope-Oliveira
BACKGROUND: Fungal infections have been commonly diagnosed in individuals with advanced HIV disease. Cryptococcosis, pneumocystosis, and histoplasmosis are the most frequent systemic mycoses in people suffering from HIV/AIDS. CASE REPORT: We report a case of multiple fungal infections in an advanced AIDS-patient. A 33-year-old HIV-positive man from Brazil was hospitalized due to diarrhea, dyspnea, emaciation, hypoxemia, extensive oral thrush, and a CD4+ T lymphocyte count of 20cells/mm(3)...
April 2016: Revista Iberoamericana de Micología
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