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Arthritis histoplasmosis

Jessica Lum, Maheen Z Abidi, Bruce McCollister, Andrés F Henao-Martínez
Miliary histoplasmosis is a rare presentation that may mimic miliary tuberculosis. We report a case of miliary histoplasmosis in a 52-year-old male who was being treated with hydroxychloroquine, methotrexate, and sulfasalazine for his rheumatoid arthritis and presented to the emergency department with shortness of breath and fevers. Computed tomography (CT) chest revealed miliary pulmonary nodules. Urine Histoplasma antigen and serum Histoplasma antigen were negative; however, Coccidioides immitis complement immunofixation assay and Coccidioides IgM were positive...
2018: Case Reports in Medicine
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...
May 2018: Journal of General Internal Medicine
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
A T Akenroye, N Madan, F Mohammadi, J Leider
Introduction. Hemophagocytic lymphohistiocytosis (HLH), a rare but potentially fatal disease, is characterized by excessive immune activation and cytokine release which stimulates bone marrow macrophages to engulf hematopoietic cells. HLH could be secondary to infections: viral, fungal, and bacterial; malignancies and autoimmune diseases. The diagnosis of HLH is usually delayed due to the presence of non-specific symptoms at presentation. This delay contributes to increased mortality. Cases and review. We present the case of 4 patients who presented with subjective fevers and extreme fatigue...
January 2017: European Annals of Allergy and Clinical Immunology
Juan E Muñoz-Oca, Martha L Villarreal Morales, Aracelis Nieves-Rodriguez, Lemuel Martínez-Bonilla
BACKGROUND: Tumor necrosis factor antagonist inhibitors have transformed the approach to patients with severe autoimmune conditions, such as rheumatoid arthritis. Although the therapy can be highly effective, TNF-α inhibitors are associated with an increased risk of opportunistic infections. CASE PRESENTATION: Here, we report a case of concomitant disseminated histoplasmosis and tuberculosis in a 65-year-old female with rheumatoid arthritis treated with TNF-α inhibitor...
January 13, 2017: BMC Infectious Diseases
Michelle Larissa Zini Lise, Henrique Luiz Staub
No abstract text is available yet for this article.
December 2016: Revista da Associação Médica Brasileira
Ramona Vesna Untanu, Syed Akbar, Stephen Graziano, Neerja Vajpayee
Hemophagocytic lymphohistiocytosis (HLH) is an aggressive and life-threating immune dysregulation syndrome characterized by persistent activation of the mononuclear phagocytic system leading to uncontrolled systemic hyperinflammatory response. The proliferation and activation of histiocytes and lymphocytes lead to production of large amounts of cytokines, also called cytokine storm. Hematopoietic and lymphoid tissues are directly involved while other organs are damaged by circulating cytokines. Primary HLH is attributed to genetic defects of the immune system and secondary HLH is usually seen in adults secondary to malignancy, infection, or autoimmune diseases...
2016: Case Reports in Infectious Diseases
H Dele Davies
Biologic response modifiers (BRMs) are substances that interact with and modify the host immune system. BRMs that dampen the immune system are used to treat conditions such as juvenile idiopathic arthritis, psoriatic arthritis, or inflammatory bowel disease and often in combination with other immunosuppressive agents, such as methotrexate and corticosteroids. Cytokines that are targeted include tumor necrosis factor α; interleukins (ILs) 6, 12, and 23; and the receptors for IL-1α (IL-1A) and IL-1β (IL-1B) as well as other molecules...
August 2016: Pediatrics
A S Dussouil, J Allardet-Servent, L Dunogeant, J L Grauer, S Ranque, V Nasser
Histoplasma capsulatum var. capsulatum is a dimorphic fungus endemic to America and subtropical regions. Several cases of this opportunist mycosis have been reported in immunocompromised patients. We report the case of a patient treated with methotrexate and corticosteroid therapy for rheumatoid arthritis and who presented with disseminated histoplasmosis that partially mimicked a dermatomyositis.
September 2015: British Journal of Dermatology
Lorenzo Falster, Maurício B Marin, João Luiz Ellera Gomes
Fungal arthritis is a rare complication of arthroscopic surgeries, but its possibility should always be considered due its deleterious effects on any joint. Infection caused by the fungus Histoplasma capsulatum is the most common cause of respiratory tract infections by fungi, meanwhile histoplasmosis arthritis is more rare than all other fungal infections. However, their atypical forms of arthritis and the importance of early diagnosis and treatment cannot be over-emphasized. Herein we report a case of knee monoarthritis in an immunocompetent patient with histoplasmosis arthritis following an arthroscopic meniscetomy, diagnosed by synovial biopsy and culture performed during a second arthroscopic procedure...
September 2015: Brazilian Journal of Infectious Diseases
Marlon van Weelden, Gabriela R Viola, Katia T Kozu, Nadia E Aikawa, Claudia M Ivo, Clovis A Silva
INTRODUCTION: Systemic histoplasmosis is an invasive fungal infection that may mimic primary vasculitis, particularly granulomatosis with polyangiitis (GPA), and was rarely described in adult patients. We reported an immunocompetent patient with disseminated histoplasmosis mimicking GPA who fulfilled European League Against Rheumatism (EULAR)/Pediatric Rheumatology International Trials Organisation (PRINTO)/Pediatric Rheumatology European Society (PRES) validated classification criteria...
March 4, 2015: Revista Brasileira de Reumatologia
Niral Patel, Andrew Worden, Rajul Patel, Javier Diaz-Mendoza, Lisa Stagner
Bronchology/Interventional Student/Resident Case Report Posters ISESSION TYPE: Medical Student/Resident Case ReportPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Endobronchial valves (EBV) were marketed for use in severe emphysematous COPD. However, they have demonstrated efficacy in managing persistent Bronchopleural Fistulas (Pneumothoraces). In 2008, the FDA approved the use of the IBV Valve System via the Humanitarian Device Exemption Program. There is still limited literature detailing the use of these valves in treating persistent air leaks, few involving thoracic infections, and none involving fungal infections...
October 1, 2014: Chest
Marlene L Durand, Derrick T Lin, Amy F Juliano, Peter M Sadow
Presentation of Case. Dr. Pritha Sen (Medicine): A 78-year-old woman with diabetes mellitus and rheumatoid arthritis was admitted to Massachusetts Eye and Ear Infirmary because of pain in the right side of the throat, odynophagia, and a right tonsillar mass. The patient had been in her usual health..
October 16, 2014: New England Journal of Medicine
Hye J Chung, Daria Marley-Kemp, Matthew Keller
The term rupioid has been used to describe well-demarcated, cone-shaped plaques with thick, dark, lamellate, and adherent crusts on the skin that somewhat resemble oyster or limpet shells. We present a case of rupioid psoriasis that was treated with methotrexate, topical steroids, and intralesional steroid injections. Rupioid manifestations have been clinically observed in a variety of disease settings, including rupioid psoriasis, reactive arthritis, disseminated histoplasmosis, keratotic scabies, secondary syphilis, and photosensitive skin lesions in association with aminoaciduria...
September 2014: Cutis; Cutaneous Medicine for the Practitioner
Nicholas Bhojwani, Jason Brett Hartman, David C Taylor, Mark Herbert, Michael Corriveau
Histoplasma capsulatum can rarely affect the trachea. We report the case of a 68-year-old woman with rheumatoid arthritis on immunosuppressive therapy who presented with fevers, worsening shortness of breath, nonproductive cough and subjective throat hoarseness and fullness. Chest computed tomography demonstrated no tracheal findings. Bronchoscopy found mucosal irregularity, nodularity and vesicular regions in the proximal trachea extending seven centimeters distal to the vocal cords. Also seen was an edematous, exudative left vocal cord with polyps and an ulcerative lesion...
March 2016: Clinical Respiratory Journal
Nancy A Rihana, Manasa Kandula, Ana Velez, Kumud Dahal, Edward B O'Neill
Background. Histoplasma capsulatum is the most common endemic mycosis in the United States and is a frequent cause of opportunistic infection in immunodeficient hosts. Histoplasmosis is most often self-limiting and goes unrecognized in the immunocompetent population but can progress to disseminated histoplasmosis in patients with an impaired immune system. Liver involvement as a part of disseminated histoplasmosis which usually originates in the lung is well known. However, extrapulmonary hepatic histoplasmosis as a primary manifestation is extremely rare...
2014: Case Reports in Medicine
I Müller-Stöver, K Tintelnot, J Richter, D Häussinger
A 55-year-old woman presented 18 months after a trip to Ecuador with night sweat, malaise, and an unclear lesion of the lung. Computed tomography of the lung showed a nodular lesion of 14 mm. Antibodies against Histoplasma capsulatum were detected in the complement fixation text (CFT) and IgG western blot. Re-examination of a formalin fixed paraffin embedded (FFPE) lung-biopsy revealed yeasts after silver staining, compatible with H. capsulatum , which was verified by extraction and amplification of DNA from FFPE...
August 2014: Der Internist
Thein Myint, Majdi N Al-Hasan, Julie A Ribes, Brian S Murphy, Richard N Greenberg
The impact of highly active antiretroviral therapy (HAART) on the epidemiology of AIDS-associated histoplasmosis in the past decade is poorly defined. Among 100 patients with histoplasmosis in an endemic region between 2000 and 2009, 42 patients were immunocompetent, 32 were infected with HIV, and 26 were non-HIV-immunocompromised patients. The percentage with HIV decreased 67% in 2000-2001 to 18% in 2008-2009 (P = .004), while the proportion of non-HIV immunocompromised patients increased, 8% to 41% (P = ...
March 2014: Journal of the International Association of Providers of AIDS Care
Roni Bitterman, Ilana Oren, Yuval Geffen, Hannah Sprecher, Eli Schwartz, Ami Neuberger
We present a case of progressive disseminated histoplasmosis in an immunocompetent traveler. Histoplasmosis was acquired in South America; its manifestations included prolonged fever, splinter hemorrhages, erythema multiforme, arthritis, and mediastinal lymphadenopathy. To the best of our knowledge no splinter hemorrhages had previously been reported in a patient with histoplasmosis.
January 2013: Journal of Travel Medicine
Lorraine Letranchant, Anne Debourgogne, Thanh Doco-Lecompte, Nelly Contet-Audonneau, Thierry May, Marie Machouart
Histoplasmosis is an infectious disease caused by the inhalation of Histoplasma capsulatum spores, a fungus encountered in many diverse areas around the world. Although this infection is often asymptomatic, it may become dramatic in immunocompromised patients. In November 2005, an endocarditis due to Histoplasma capsulatum was diagnosed in a French woman treated for rheumatoid arthritis and who had traveled to South America 2 years earlier. We confirmed the biological diagnosis by mycological, serological, and histological methods...
March 2012: Mycopathologia
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