scholarly journals Bats, Fever and Adenopathy – What Is the Link?

2013 ◽  
Vol 24 (1) ◽  
pp. 35-37 ◽  
Author(s):  
Joshua J Manolakos ◽  
Mohan Cooray ◽  
Ameen Patel ◽  
Shariq Haider
Keyword(s):  
Costa Rica ◽  
Environmental Exposure ◽  
Salvage Therapy ◽  
Histoplasma Capsulatum ◽  
Treatment Options ◽  
Diagnostic Approach ◽  
Disseminated Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis

A case of travel-related, subacute, progressive disseminated histoplasmosis in a nonimmunocompromised individual is described. The present case highlights the environmental exposure toHistoplasma capsulatumin Costa Rica, the diagnostic approach and treatment options, as well as new alternatives for salvage therapy for histoplasmosis infection.

scholarly journals Typical Facial Lesions: A Window of Suspicion for Progressive Disseminated Histoplasmosis—A Case of Asian Prototype

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Prasan K. Panda ◽  
Siddharth Jain ◽  
Rita Sood ◽  
Rajni Yadav ◽  
Naval K. Vikram
Keyword(s):  
Histoplasma Capsulatum ◽  
Bone Marrow Aspiration ◽  
Febrile Illness ◽  
Immunocompetent Patient ◽  
Dimorphic Fungus ◽  
Recent Onset ◽  
Disseminated Histoplasmosis ◽  
The Face ◽  
History Of ◽  
Progressive Disseminated Histoplasmosis

Histoplasmosis is caused by a dimorphic fungusHistoplasma capsulatumin 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. Antemortem skin biopsy and bone marrow aspiration along with postmortem liver, lung, and spleen biopsy showed disseminated histoplasmosis. This case highlights the need for an early suspicion of progressive disseminated histoplasmosis in the presence of classical mucocutaneous lesions even in an immunocompetent patient suffering from a febrile illness. Cure rate approaches almost 100% with early treatment, whereas it is universally fatal if left untreated.

scholarly journals Detection of Histoplasma capsulatum Antigen in Panamanian Patients with Disseminated Histoplasmosis and AIDS

2008 ◽  
Vol 15 (4) ◽  
pp. 681-683 ◽  
Author(s):  
Maria Eugenia Gutierrez ◽  
Alfredo Canton ◽  
Patricia Connolly ◽  
Robert Zarnowski ◽  
L. Joseph Wheat
Keyword(s):  
United States ◽  
Latin American ◽  
Histoplasma Capsulatum ◽  
Severe Disease ◽  
Nuclear Gene ◽  
The United States ◽  
Antigen Detection ◽  
Disseminated Histoplasmosis ◽  
Antigen Assay ◽  
Progressive Disseminated Histoplasmosis

ABSTRACT Histoplasmosis is a common endemic mycosis in the Americas, often causing severe disease in patients with AIDS. Antigen detection has become an important method for rapid diagnosis of histoplasmosis in the United States but not in Central or South America. Isolates from patients in the United States are predominantly found to be class 2 isolates when typed using the nuclear gene YPS3, while isolates from Latin America are predominantly typed as class 5 or class 6. Whether infection with these Latin American genotypes produces positive results in the Histoplasma antigen assay has not been reported. In this study, we have compared the sensitivity of antigen detection for AIDS patients from Panama who had progressive disseminated histoplasmosis to that for those in the United States. Antigenuria was detected in the MVista Histoplasma antigen enzyme immunoassay (EIA) in 95.2% of Panamanian cases versus 100% of U.S. cases. Antigenemia was detected in 94.7% of the Panamanian cases versus 92% of the U.S. cases. Two clinical isolates from Panama were typed using YPS3 and were found to be restriction fragment length polymorphism class 6. We conclude that the MVista Histoplasma antigen EIA is a sensitive method for diagnosis of histoplasmosis in Panama.

scholarly journals Multicenter Validation of Commercial Antigenuria Reagents To Diagnose Progressive Disseminated Histoplasmosis in People Living with HIV/AIDS in Two Latin American Countries

2018 ◽  
Vol 56 (6) ◽  
Author(s):  
Diego H. Cáceres ◽  
Blanca E. Samayoa ◽  
Narda G. Medina ◽  
Angela M. Tobón ◽  
Brenda J. Guzmán ◽  
...  
Keyword(s):  
Latin American ◽  
Histoplasma Capsulatum ◽  
Enzyme Linked Immunosorbent Assay ◽  
People Living With Hiv ◽  
Content Type ◽  
Disseminated Histoplasmosis ◽  
Wide Range ◽  
Progressive Disseminated Histoplasmosis ◽  
Living With Hiv ◽  
Hiv Aids

ABSTRACTHistoplasmosis 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 detectHistoplasma capsulatuminfection in regions where histoplasmosis is endemic would dramatically decrease the time to diagnosis and treatment, reducing morbidity and mortality. The aim of this study was to validate a commercial monoclonalHistoplasmagalactomannan (HGM) enzyme-linked immunosorbent assay (Immuno-Mycologics [IMMY], Norman, OK, USA) in two cohorts of people living with HIV/AIDS (PLHIV). We analyzed urine samples from 589 people (466 from Guatemala and 123 from Colombia), including 546 from PLHIV and 43 from non-PLHIV controls. Sixty-three of these people (35 from Guatemala and 28 from Colombia) had confirmed histoplasmosis by isolation ofH. capsulatum. Using the standard curve provided by the quantitative commercial test, the sensitivity was 98% (95% confidence interval [CI], 95 to 100%) and the specificity was 97% (95% CI, 96 to 99%) (cutoff = 0.5 ng/ml). Semiquantitative results, using a calibrator of 12.5 ng/ml ofHistoplasmagalactomannan to calculate an enzyme immunoassay index value (EIV) for the samples, showed a sensitivity of 95% (95% CI, 89 to 100%) and a specificity of 98% (95% CI, 96 to 99%) (cutoff ≥ 2.6 EIV). This relatively simple-to-perform commercial antigenuria test showed a high performance with reproducible results in both countries, suggesting that it can be used to detect progressive disseminated histoplasmosis in PLHIV in a wide range of clinical laboratories in countries where histoplasmosis is endemic.

scholarly journals An Italian Case of Disseminated Histoplasmosis Associated with HIV

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Chiara Papalini ◽  
Barbara Belfiori ◽  
Giovanni Martino ◽  
Rita Papili ◽  
Lucia Pitzurra ◽  
...  
Keyword(s):  
Histoplasma Capsulatum ◽  
Opportunistic Infections ◽  
Culture Method ◽  
Peripheral Blood Smear ◽  
Smear Microscopy ◽  
Dimorphic Fungus ◽  
Italian Case ◽  
Disseminated Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis ◽  
One Year

Histoplasma capsulatum is a dimorphic fungus, endemic in the Americas, Africa (var. duboisii), India, and Southeast Asia. H. capsulatum infection is rarely diagnosed in Italy, while in Latin America, progressive disseminated histoplasmosis (PDH) is one of the most frequent AIDS-defining illnesses and causes of AIDS-related deaths. We report a case of PDH and new HIV infection diagnosis in a Cuban patient, who has been living in Italy for the past 10 years. Bone marrow aspirate and peripheral blood smear microscopy suggested H. capsulatum infection. The diagnosis was confirmed with the culture method identifying its thermal dimorphism. Liposomal amphotericin B was administered alone for 10 days and then for another 2 days, accompanied with voriconazole; the former was stopped for probable side effects (persistent fever and worsening thrombocytopenia), and voriconazole was continued to complete 4 weeks. PDH maintenance treatment consisted of itraconazole for one year. Antiretroviral therapy (ART) was started on the third week of antifungal treatment. At the 3-year follow-up, the patient is adherent on ART, the virus was suppressed, and she has an optimal immune recovery. This case highlights the need to suspect histoplasmosis in the differential diagnosis of opportunistic infections in immunocompromised persons, native to or who have traveled to endemic countries.

scholarly journals Progressive disseminated histoplasmosis with pulmonary and central nervous system involvement: a case report

2021 ◽  
Author(s):  
Matheus Fellipe Nascimento de Souza ◽  
Ana Paula Teixeira da Silva ◽  
Gabriela Santos Bianchin ◽  
Maria Eduarda Angelo de Mendonça Fileti ◽  
Raddib Eduardo Noleto da Nóbrega de Oliveira ◽  
...  
Keyword(s):  
Case Report ◽  
Histoplasma Capsulatum ◽  
Systemic Disease ◽  
Central Nervous System Involvement ◽  
Tnf Alpha ◽  
Cns Involvement ◽  
Necrosis Factor Alpha ◽  
Adequate Treatment ◽  
Disseminated Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis

Context: Histoplasmosis (Histoplasma capsulatum) is a systemic disease that affects the lung and immune system1. The severity of histoplasmosis is directly related to the individual’s immune response since it is an opportunistic pathogen2. It is one of the most prevalent infections in immunocompromised patients due to the use of tumor necrosis factor-alpha (TNF-alpha) inhibitors, resulting in a mortality rate of 20%. The evolution to CNS occurs in 5-10% of patients with disseminated symptoms3. Case Report: M.G.M, a woman, 67 years, was admitted with bilateral tonicclonic seizure with focal onset in the right upper limb. The patient had hypertension, diabetes and rheumatoid arthritis, and was use ASA, glibenclamide, hydrochlorothiazide, losartan, amlodipine, adalimumab and methotrexate. Complementary exams were performed that showed lesions suggestive of microangiopathy on cranial CT; nodular lesions in the pulmonary right upper lobe and prominent lymph nodes in the hilum and mediastinum on chest CT; CSF with increased cytology (monomorphonuclear predominance), without glucose consumption. The biopsy of lung lesions identified Histoplasma capsulatum, confirming the diagnosis of progressive disseminated histoplasmosis with pulmonary and CNS involvement. Thus, treatment with amphotericin B was started, however, the patient died. Conclusions: Histoplasmosis is the most prevalent invasive fungal infection in users of TNF-alpha inhibitors. In these cases, the disease can be more aggressive and have a rapid evolution, with CNS involvement - which confers a worse prognosis. Early diagnosis, suspension of the immunomodulator and adequate treatment for infection control are required.

scholarly journals Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

2021 ◽  
Vol 7 (6) ◽  
pp. 481
Author(s):  
Spinello Antinori ◽  
Andrea Giacomelli ◽  
Mario Corbellino ◽  
Alessandro Torre ◽  
Marco Schiuma ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hiv Infection ◽  
Histoplasma Capsulatum ◽  
People Living With Hiv ◽  
Immunocompromised Patients ◽  
Dimorphic Fungus ◽  
Endemic Region ◽  
Disseminated Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis ◽  
Living With Hiv

Human histoplasmosis is a mycosis caused by two distinct varieties of a dimorphic fungus: Histoplasma capsulatum var. capsulatum and H. capsulatum var. duboisii. In Europe, it is usually imported by migrants and travellers, although there have been some autochthonous cases, especially in Italy; however, most European physicians are unfamiliar with its clinical and pathological picture, particularly among immunocompromised patients without HIV infection. This systematic review of all the cases of histoplasmosis reported in Europe and Israel between 2005 and 2020 identified 728 cases diagnosed in 17 European countries and Israel described in 133 articles. The vast majority were imported (mainly from Central and South America), but there were also seven autochthonous cases (six in Europe and one in Israel). The patients were prevalently males (60.4%), and their ages ranged from 2 to 86 years. The time between leaving an endemic region and the diagnosis of histoplasmosis varied from a few weeks to more than 40 years. Progressive disseminated histoplasmosis was the most frequent clinical picture among people living with HIV infection (89.5%) or a different immunocompromising condition (57.1%), but it was also recorded in 6.2% of immunocompetent patients. Twenty-eight cases were caused by Histoplasma duboisii. Immunocompromised patients without HIV infection had the worst outcomes, with a mortality rate of 32%.

scholarly journals DISSEMINATED HISTOPLASMOSIS AS AIDS PRESENTATION. CASE REPORT AND COMPREHENSIVE REVIEW OF CURRENT LITERATURE

2018 ◽  
Vol 10 (1) ◽  
pp. e2018040 ◽  
Author(s):  
Paola Zanotti ◽  
Claudia Chirico ◽  
Maurizio Gulletta ◽  
Laura Ardighieri ◽  
Salvatore Casari ◽  
...  
Keyword(s):  
Treatment Options ◽  
Clinical Manifestations ◽  
Diagnostic Tools ◽  
Newly Diagnosed ◽  
Comprehensive Review ◽  
Haemophagocytic Syndrome ◽  
Disseminated Histoplasmosis ◽  
Wide Range ◽  
Progressive Disseminated Histoplasmosis ◽  
Main Barrier

Progressive disseminated histoplasmosis (PDH) is an AIDS-defining illness with a high lethality rate if not promptly treated. The wide range of its possible clinical manifestations represents the main barrier to diagnosis in non-endemic countries. Here we present a case of PDH with haemophagocytic syndrome in a newly diagnosed HIV patient and a comprehensive review of disseminated histoplasmosis focused on epidemiology, clinical features, diagnostic tools and treatment options in HIV-infected patients.

Treatment Of Disseminated Histoplasmosis With Ethyl Vanillate

PEDIATRICS ◽  
1951 ◽  
Vol 7 (1) ◽  
pp. 7-18
Author(s):  
AMOS CHRISTIE ◽  
JAMES G. MIDDLETON ◽  
J. CYRIL PETERSON ◽  
DAVID L. MCVICKAR
Keyword(s):  
Disseminated Histoplasmosis ◽  
Progressive Disseminated Histoplasmosis

Some of the physical and pharmacologic properties of ethyl vanillate, a new fungistatic or fungicidal agent, have been briefly stated. The records of 12 patients with progressive disseminated histoplasmosis treated with ethyl vanillate have been reviewed. Five of these patients are alive and apparently well following treatment, an experience not previously encountered or reported in the literature. The use of the drug in the treatment of histoplasmosis has been outlined and the toxic manifestations of overdosage have been described.

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