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Diego H Cáceres, Blanca E Samayoa, Narda G Medina, Angela M Tobón, Brenda J Guzmán, Danicela Mercado, Angela Restrepo, Tom Chiller, Eduardo E Arathoon, Beatriz L Gómez
Histoplasmosis is an important cause of mortality in patients with AIDS, especially in countries with limited access to antiretroviral therapies and diagnostic tests. However, many disseminated infections in Latin America go undiagnosed. A simple, rapid method to detect Histoplasma capsulatum infection in endemic regions would dramatically decrease time to diagnosis and treatment, reducing morbidity and mortality. The aim of this study was to validate a commercial monoclonal Histoplasma galactomannan (HGM) ELISA (Immuno-Mycologics [IMMY], Norman, Oklahoma, USA) in two cohorts of people living with HIV/AIDS (PLHIV)...
March 21, 2018: Journal of Clinical Microbiology
Marina Macedo-Viñas, David W Denning
We aimed to estimate for the first time the burden of fungal infections in Uruguay. Data on population characteristics and underlying conditions were extracted from the National Statistics Institute, the World Bank, national registries, and published articles. When no data existed, risk populations were used to estimate frequencies extrapolating from the literature. Population structure (inhabitants): total 3,444,006; 73% adults; 35% women younger than 50 years. Size of populations at risk (total cases per year): HIV infected 12,000; acute myeloid leukemia 126; hematopoietic stem cell transplantation 30; solid organ transplants 134; COPD 272,006; asthma in adults 223,431; cystic fibrosis in adults 48; tuberculosis 613; lung cancer 1400...
March 18, 2018: Journal of Fungi (Basel, Switzerland)
Matthew T Koroscil, Andrew Skabelund
Introduction: Blastomyces dermatitidis is a dimorphic fungus endemic to the Mississippi River valley. We describe a rare case of chronic pulmonary blastomycosis complicated by large pulmonary cavitation in a young service member who was misdiagnosed with active pulmonary tuberculosis. Case Presentation: A 25-year-old active duty male presented to his primary care provider with complaints of hemoptysis, fatigue, weight loss, and fever. Computed tomography chest with contrast identified a large cavitary lesion in the right upper lobe (RUL)...
March 14, 2018: Military Medicine
Bryan R Anderson, Jaron Marriott, Chinthaka Bulathsinghala, Humayun Anjum, Salim Surani
Introduction: Gastrointestinal histoplasmosis (GH) is a well-described albeit uncommon disease. It is found almost exclusively in the immunocompromised host, especially those with untreated HIV and low CD4 counts. Presentation with intestinal perforation is seen mostly commonly in the colon. We present a patient with jejunal perforation, and there have been only 3 previous cases reported in the literature. Case: A 39-year-old male with known, untreated HIV presented to the ED with an acute abdomen after experiencing worsening intermittent abdominal pain for 2 months before that was associated with nausea, vomiting, diarrhea, and weight loss...
2018: Case Reports in Medicine
Luisa F Gómez, Isaura P Torres, María Del P Jiménez, Juan G McEwen, Catalina de Bedout, Carlos A Peláez, José M Acevedo, María L Taylor, Myrtha Arango
Histoplasma capsulatum is the causative agent of histoplasmosis and this fungus inhabits soils rich in phosphorus and nitrogen that are enriched with bird and bat manure. The replacement of organic matter in agroecosystems is necessary in the tropics, and the use of organic fertilizers has increased. Cases and outbreaks due to the presence of the fungus in these components have been reported. The Instituto Colombiano Agropecuario resolution 150 of 2003 contains the parameters set by the Colombian Technical Standard (NTC 5167) on the physicochemical and microbiological features of fertilizers, but it does not regulate the search for H...
March 12, 2018: American Journal of Tropical Medicine and Hygiene
Nina Jain, Jeffrey B Doyon, Jacob E Lazarus, Inga-Marie Schaefer, Melanie E Johncilla, Agoston T Agoston, Anuj K Dalal, Gustavo E Velásquez
Biologic agents are effective treatments for rheumatoid arthritis but are associated with important risks, including severe infections. Tumor Necrosis Factor (TNF) α inhibitors are known to increase the risk of systemic fungal infections such as disseminated histoplasmosis. Abatacept is a biologic agent with a mechanism different from that of TNFα inhibitors: It suppresses cellular immunity by competing for the costimulatory signal on antigen-presenting cells. The risk of disseminated histoplasmosis for patients on abatacept is not known...
March 12, 2018: Journal of General Internal Medicine
Kevin Kuriakose, Whitney Jones-Nesbitt, Matthew Greene, Bryan Harris
A woman in her late 60s with disseminated histoplasmosis was treated with posaconazole since first-line therapies were not tolerated. She subsequently presented with decompensated heart failure, hypertension, and hypokalemia. Labs revealed low renin and aldosterone levels. A potential mechanism is inhibition of the enzyme 11 beta-hydroxysteroid dehydrogenase 2, with resultant apparent mineralocorticoid excess.
March 12, 2018: Antimicrobial Agents and Chemotherapy
Weijie Li, Mukta Sharma
No abstract text is available yet for this article.
March 8, 2018: Blood
N Fakhfakh, R Abdelmlak, S Aissa, A Kallel, Y Boudawara, S Bel Hadj, N Ben Romdhane, H Touiri Ben Aissa, K Kallel
Histoplasmosis is a fungal infection caused by a dimorphic fungus, Histoplasma capsulatum. We report a first case of disseminated histoplasmosis in a 34-year-old woman, infected with human immunodeficiency virus (HIV), originating from Ivory Coast and living in Tunisia for 4 years. She was complaining from fever, chronic diarrhoea and pancytopenia. The Histoplasma capsulatum var. capsulatum was identified by direct microscopic examination of the bone marrow. She was treated by Amphotericin B, relayed by itraconazole...
March 5, 2018: Journal de Mycologie Médicale
Xin-Bo Ai, Zhen-Jiang Wang, Qi-Chao Dong, Xu Lin, Yu-Ping Chen, Fei-Yue Gong, Hui Liang
Gastrointestinal histoplasmosis (GIH) without pulmonary and bone marrow involvement is very rare worldwide. It can be misdiagnosed as intestinal tuberculosis or Crohn's disease. There are just few case reports of GIH in patients with a positive HIV antibody test. Here, we report a patient who presented to our hospital with repeated intestinal obstruction. The suspicious diagnosis was intestinal tuberculosis or Crohn's disease due to unspecific clinical manifestations and radiologic images. Our patient's HIV antibody test was negative...
January 2018: Case Reports in Gastroenterology
Jennifer E McGill, Andrew S Hanzlicek, Kate S Kukanich, Gary D Norsworthy, Audrey K Cook
Objectives The objective of this study was to determine if urine Histoplasma antigen ( HAg) enzyme immunoassay (EIA) concentrations at the time of diagnosis and prior to the administration of antifungal agents are predictive of outcome for cats infected with Histoplasma capsulatum and to determine if compromised renal function affects urine HAg EIA measurements. Methods Medical records at four institutions were searched to identify cats diagnosed with histoplasmosis between April 2012 and December 2015. Pretreatment urine Histoplasma EIA values were recorded, along with patient signalment, serum creatinine concentration, urine specific gravity, site(s) of infection and survival data...
March 1, 2018: Journal of Feline Medicine and Surgery
W Samir Cubas, Gerardo Jiménez, Juan Vega
The dermatological manifestations of disseminated histoplasmosis present in about 17% of the cases, is a challenge for its diagnosis. We report the case of a patient from the northern coast of Peru, who presented diffuse dermal lesions, erythema-violaceous nodules, and ulcers histopathologically compatible with the infection of the genus Histoplasma var. capsulatum.
December 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Diane Libert, Gary W Procop, Mohammad Q Ansari
Objectives: Serum and urine antigen (SAg, UAg) detection are common tests for Histoplasma capsulatum. UAg detection is more widely used and reportedly has a higher sensitivity. We investigated whether SAg detection contributes meaningfully to the initial evaluation of patients with suspected histoplasmosis. Methods: We reviewed 20,285 UAg and 1,426 SAg tests ordered from 1997 to 2016 and analyzed paired UAg and SAg tests completed on the same patient within 1 week...
March 7, 2018: American Journal of Clinical Pathology
Paige A Armstrong, Brendan R Jackson, Dirk Haselow, Virgie Fields, Malia Ireland, Connie Austin, Kimberly Signs, Veronica Fialkowski, Reema Patel, Peggy Ellis, Peter C Iwen, Caitlin Pedati, Suzanne Gibbons-Burgener, Jannifer Anderson, Thomas Dobbs, Sherri Davidson, Mary McIntyre, Kimberly Warren, Joanne Midla, Nhiem Luong, Kaitlin Benedict
Histoplasmosis is one of the most common mycoses endemic to the United States, but it was reportable in only 10 states during 2016, when a national case definition was approved. To better characterize the epidemiologic features of histoplasmosis, we analyzed deidentified surveillance data for 2011-2014 from the following 12 states: Alabama, Arkansas, Delaware, Illinois, Indiana, Kentucky, Michigan, Minnesota, Mississippi, Nebraska, Pennsylvania, and Wisconsin. We examined epidemiologic and laboratory features and calculated state-specific annual and county-specific mean annual incidence rates...
March 2017: Emerging Infectious Diseases
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
Daniel Molina-Morant, Adrián Sánchez-Montalvá, Fernando Salvador, Augusto Sao-Avilés, Israel Molina
Endemic mycoses are systemic fungal infections. Histoplasmosis is endemic in all temperate areas of the world; coccidioidomycosis and paracoccidioidomycosis are only present in the American continent. These pathogens are not present in Spain, but in the last years there has been an increase of reported cases due to migration and temporary movements. We obtained from the Spanish hospitals records clinical and demographic data of all hospitalized cases between 1997 and 2014. There were 286 cases of histoplasmosis, 94 of Coccidioidomycosis and 25 of paracoccidioidomycosis...
February 15, 2018: PLoS Neglected Tropical Diseases
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
Nam K Ku, Sheeja T Pullarkat, Young S Kim, Liang Cheng, Dennis O'Malley
In pathologic specimen, Histoplasma capsulatum can frequently be identified by morphology and special stains such as GMS and PAS. Incidentally, we noted unusual staining of the platelet associated marker CD42b/GP1b expressed on the surface of fungal organisms. Evaluation of additional cases demonstrated that a majority of histoplasmosis cases (15/18 cases; 83%) showed positive staining with CD42b/GP1b, comparable to GMS stain results. Other platelet associated markers such as Factor VIII and CD61 showed no or rare expression (1/18 cases with Factor VIII)...
February 2018: Annals of Diagnostic Pathology
Tomasz Chroboczek, Julie Dufour, Alain Renaux, Christine Aznar, Magalie Demar, Pierre Couppie, Antoine Adenis
HIV-associated histoplasmosis is mainly misdiagnosed for granulomatous diseases, such as tuberculosis. Nonetheless, malignancy-like lesions have been reported sporadically in HIV-infected patients. Although the main reported lesions are erosive or ulcerated, here a rare case of oral tumor is reported. This case raises the awareness of this presentation, and the importance of accurate identification in the laboratory. Performing systematic specific stains for fungal elements and culture on tissue samples ensures accurate differential diagnosis...
March 2018: Medical Mycology Case Reports
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