1
|
Schulze AB, Heptner B, Kessler T, Baumgarten B, Stoica V, Mohr M, Wiewrodt R, Warneke VS, Hartmann W, Wüllenweber J, Schülke C, Schäfers M, Wilmes D, Becker K, Schmidt LH, Groll AH, Berdel WE. Progressive histoplasmosis with hemophagocytic lymphohistiocytosis and epithelioid cell granulomatosis: A case report and review of the literature. Eur J Haematol 2017; 99:91-100. [DOI: 10.1111/ejh.12886] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2017] [Indexed: 01/08/2023]
Affiliation(s)
| | - Britta Heptner
- Department of Medicine A; University Hospital Muenster; Muenster Germany
| | - Torsten Kessler
- Department of Medicine A; University Hospital Muenster; Muenster Germany
| | - Birgit Baumgarten
- Department of Medicine A; University Hospital Muenster; Muenster Germany
| | - Viorelia Stoica
- Department of Medicine B; University Hospital Muenster; Muenster Germany
| | - Michael Mohr
- Department of Medicine A; University Hospital Muenster; Muenster Germany
| | - Rainer Wiewrodt
- Department of Medicine A; University Hospital Muenster; Muenster Germany
| | | | - Wolfgang Hartmann
- Gerhard Domagk Institute of Pathology; University Hospital Muenster; Muenster Germany
| | - Jörg Wüllenweber
- Institute of Medical Microbiology; University Hospital Muenster; Muenster Germany
| | - Christoph Schülke
- Department of Clinical Radiology; University Hospital Muenster; Muenster Germany
| | - Michael Schäfers
- Department of Nuclear Medicine; University Hospital Muenster; Muenster Germany
| | - Dunja Wilmes
- National Reference Center for Cryptococcosis, Scedosporiosis, and Endemic Mycoses; Robert Koch Institute; Berlin Germany
| | - Karsten Becker
- Institute of Medical Microbiology; University Hospital Muenster; Muenster Germany
| | | | - Andreas H. Groll
- Infectious Disease Research Program; Department of Pediatric Hematology/Oncology; Center for Bone Marrow Transplantation; University Hospital Muenster; Muenster Germany
| | - Wolfgang E. Berdel
- Department of Medicine A; University Hospital Muenster; Muenster Germany
| |
Collapse
|
2
|
Abstract
All of the endemic mycoses have cutaneous and mucocutaneous manifestations that are most commonly seen when patients have disseminated infection. Biopsy of skin lesions is simple and safe and can assist in making a timely diagnosis of disseminated infection. Primary cutaneous inoculation infection has been reported with all of the endemic mycoses, but is rare. In this situation, a nodule or ulcer occurs at the inoculation site, is often accompanied by lymphangitis and regional lymphadenopathy, and systemic symptoms and signs as almost always absent. Mucosal lesions are common with disseminated histoplasmosis, but also have been described in patients who have disseminated blastomycosis and coccidioidomycosis. Biopsy is essential to rule out cancer and allows a rapid diagnosis of the endemic fungal infection.
Collapse
Affiliation(s)
- Jeannina A Smith
- Division of Infectious Diseases, University of Wisconsin School of Medicine, 1685 Highland Avenue, Centennial Building, 5th Floor, Madison, WI, USA,
| | | | | |
Collapse
|
3
|
Gomez-Moyano E, Crespo-Erchiga V, Vera-Casaño A. Probable primary cutaneous histoplasmosis in a patient infected with HIV. J Mycol Med 2011; 21:210-3. [PMID: 24451565 DOI: 10.1016/j.mycmed.2011.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2011] [Accepted: 05/23/2011] [Indexed: 10/18/2022]
Abstract
Histoplasmosis is a fungal infection caused by a dimorphic fungus, Histoplasma capsulatum. Most infections occur after inhalation of fungal spores. A wide variety of clinical manifestations can occur depending on the host response and the extent of inoculation. We report a case of probable cutaneous histoplasmosis after trauma in a 26-year-old man from Paraguay who was also infected with the human immunodeficiency virus. Diagnosis was based on histological and mycological examination. No systemic involvement was found.
Collapse
|
4
|
A human immunodeficiency virus-positive infant with probable congenital histoplasmosis in a nonendemic area. Pediatr Infect Dis J 2010; 29:1055-7. [PMID: 20526228 DOI: 10.1097/inf.0b013e3181e691ed] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 5-week-old infant presented with a fever, and was diagnosed with congenital human immunodeficiency virus and histoplasmosis. Both infections were likely transmitted vertically. The child was effectively treated with antifungal medications and highly active antiretroviral therapy. This represents the first case of delayed presentation of vertically transmitted histoplasmosis, and the first case in a nonendemic area.
Collapse
|
5
|
Saheki MN, Schubach ADO, Salgueiro MDM, Conceição-Silva F, Wanke B, Lazera M. [Primary cutaneous histoplasmosis: case report on an immunocompetent patient and review of the literature]. Rev Soc Bras Med Trop 2009; 41:680-2. [PMID: 19142453 DOI: 10.1590/s0037-86822008000600024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2007] [Accepted: 11/25/2008] [Indexed: 11/21/2022] Open
Abstract
This report describes a case of primary cutaneous histoplasmosis in a 45-year-old male. The presentation consisted of an erythematous nodule on the back of the right hand, accompanied by nontender regional lymphadenomegaly that developed following local trauma that occurred during military training in a tunnel inhabited by bats. Histological examination of a biopsy specimen from the skin lesion showed granulomatous infiltrate, but did not show fungal elements. Culturing of this material, incubated in Sabouraud agar, showed growth of Histoplasma capsulatum. No evidence of systemic involvement or immunosuppression was found. Treatment with 400 mg/day of itraconazole orally for six months resulted in complete remission of the lesion, which was maintained one year after the end of the treatment.
Collapse
Affiliation(s)
- Mauricio Naoto Saheki
- Serviço de Infectologia, Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
| | | | | | | | | | | |
Collapse
|
6
|
|
7
|
Histoplasma capsulatum recovery from the urine and a short review of genitourinary histoplasmosis. Mycopathologia 2009; 167:315-23. [PMID: 19184526 DOI: 10.1007/s11046-009-9182-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Accepted: 11/08/2007] [Indexed: 10/21/2022]
Abstract
Although virtually any organ can be involved in disseminated histoplasmosis, the recovery of Histoplasma capsulatum from the urine is a rare finding. Here we describe that a renal transplant recipient had H. capsulatum recovered from urinary sediment. The organism was also recovered from urine cultures. The potential implications of this finding are discussed, and the literature on genitourinary histoplasmosis is reviewed.
Collapse
|
8
|
Lionakis MS, Samonis G, Kontoyiannis DP. Endocrine and metabolic manifestations of invasive fungal infections and systemic antifungal treatment. Mayo Clin Proc 2008; 83:1046-60. [PMID: 18775205 DOI: 10.4065/83.9.1046] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Systemic fungal infections are increasingly reported in immunocompromised patients with hematological malignancies, recipients of bone marrow and solid organ allografts, and patients with AIDS. Mycoses may infiltrate endocrine organs and adversely affect their function or produce metabolic complications, such as hypopituitarism, hyperthyroidism or hypothyroidism, pancreatitis, hypoadrenalism, hypogonadism, hypernatremia or hyponatremia, and hypercalcemia. Antifungal agents used for prophylaxis and/or treatment of mycoses also have adverse endocrine and metabolic effects, including hypoadrenalism, hypogonadism, hypoglycemia, dyslipidemia, hypernatremia, hypocalcemia, hyperphosphatemia, hyperkalemia or hypokalemia, and hypomagnesemia. Herein, we review how mycoses and conventional systemic antifungal treatment can affect the endocrine system and cause metabolic abnormalities. If clinicians are equipped with better knowledge of the endocrine and metabolic complications of fungal infections and antifungal therapy, they can more readily recognize them and favorably affect outcome.
Collapse
Affiliation(s)
- Michail S Lionakis
- Department of Infectious Diseases, Infection Control and Employee Health, The University of Texas M D Anderson Cancer Center, Houston, TX 77030, USA
| | | | | |
Collapse
|
9
|
Ariyanayagam-Baksh SM, Baksh FK, Cartun RW, Sieber PR. Histoplasma phimosis: an uncommon presentation of a not uncommon pathogen. Am J Dermatopathol 2007; 29:300-2. [PMID: 17519632 DOI: 10.1097/dad.0b013e318033348a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Infection from Histoplasma capsulatum is usually subclinical, but it also can be disseminated in patients with a compromised immune status. Involvement of the external genitalia is a rare finding, occurring by direct contact or hematogenous spread. We present a case of histoplasma posthitis in a 71-year-old man, manifesting with the extremely unusual presentation of phimosis. The diagnosis was confirmed using an immunohistochemical stain.
Collapse
|
10
|
Krunic AL, Carag H, Medenica MM, Lorincz AL. A case of primary cutaneous histoplasmosis in a patient with diabetes and multi-infarct dementia. J Dermatol 2002; 29:797-802. [PMID: 12532047 DOI: 10.1111/j.1346-8138.2002.tb00226.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2002] [Accepted: 10/22/2002] [Indexed: 11/28/2022]
Abstract
We report a case of primary cutaneous histoplasmosis in a fifty-year-old African-American woman with diabetes and multi-infarct dementia. The patient developed fever and crusted, nodulo-ulcerative lesions of the skin after accidental superficial trauma to the forehead. The biopsy revealed suppurative granulomatous inflammation with intracellular and extracellular yeast-like cells with associated clear halo measuring 3-4 mm in size. Systemic involvement was not found. The lesions cleared after treatment with itraconazole 200 mg twice a day for 3 weeks. The medication was continued for a total period of 3 months, with no signs of recurrence after one-year of follow-up.
Collapse
|
11
|
Abstract
Fungi cause 8% of nosocomial infections. This is caused, in part, by the increasing pool of immunocompromised patients. Elderly, transplant and HIV patients, as well as premature infants, have become prime candidates for invasive fungal infections. The widespread use of broad spectrum antibiotics plays a role. Utilisation of appropriate antifungal treatment modalities requires an understanding of the pathogenesis of infection. This is a challenging problem as fungi can cause different clinical manifestations that depend on the type of fungal species and patient response to the infection. Although Candida spp. are the most frequent pathogen, other species such as Aspergillus and Cryptococcus have become major pathogens. Environmental fungi which include Blastomyces, Coccidioides and Histoplasma have become more aggressive in the vulnerable patient. The genitourinary system can be a source or target of disseminated fungal infection. Diagnosis depends on clinical awareness, utilisation of appropriate diagnostic modalities, imaging modalities and a thorough clinical assessment. The treatment of primary (Blastomyces, Coccidioides, Histoplasma) infection generally requires amphotericin B (AmpB). The opportunistic infections (Aspergillus, Cryptococcus and Candida) may respond to the triazoles although AmpB remains the 'gold standard'. Infections caused by Candida spp. represents the greatest challenge to the clinician. The presence of Candida spp. in the urine may indicate colonisation or infection. Untreated, Candida can remain as a 'saprophyte' or develop ascending infection, sepsis or death. The prophylactic use of fluconazole may in itself result in resistant infection, hence the 'conundrum'.
Collapse
Affiliation(s)
- G J Wise
- Division of Urology, Maimonides Medical Center, Brooklyn, New York 11219, USA.
| |
Collapse
|
12
|
Romano C, Castelli A, Laurini L, Massai L. Case report. Primary cutaneous histoplasmosis in an immunosuppressed patient. Mycoses 2000; 43:151-4. [PMID: 10907346 DOI: 10.1046/j.1439-0507.2000.00563.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A case of cutaneous histoplasmosis is reported in an 80-year-old man with rheumatoid arthritis who had been treated with steroid therapy for 15 years. The patient developed a large ulcerative lesion on the back of the left hand and on the distal third of the left dorsal forearm after a slight trauma. Diagnosis was based on histological and mycological examination. Systemic involvement was not found. The lesions healed after 2 months of therapy with 100 mg day-1 fluconazole, confirmed at follow-up 1 year later.
Collapse
|
13
|
Wise GJ, Talluri GS, Marella VK. Fungal infections of the genitourinary system: manifestations, diagnosis, and treatment. Urol Clin North Am 1999; 26:701-18, vii. [PMID: 10584612 DOI: 10.1016/s0094-0143(05)70212-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
There is an increasing pool of immunocompromised patients who are at an increased risk to fungi infections, which now cause 8% of nosocomial infections. Premature infants and elderly, transplant, and HIV patients are prime candidates for invasive fungal infections. The genitourinary system can be a source or target of disseminated fungal infection. Although candidal species are the most frequent pathogen, other species such as aspergila, cryptoccoccus have become major pathogens. "Environmental fungi," which include blastomyces, coccidioides and histoplasma, have become more aggressive in the vulnerable patient.
Collapse
Affiliation(s)
- G J Wise
- Division of Urology, Maimonides Medical Center, Brooklyn, New York, USA.
| | | | | |
Collapse
|
14
|
Abstract
The lymphocutaneous syndrome can be caused by a number of diverse microorganisms requiring very different antimicrobial therapy for resolution. The epidemiology and geographic occurrence of the infection often can provide important first clues to the microbiologic etiology. Accurate diagnosis can be accomplished usually by punch or wedge biopsy of a primary lesion or proximal subcutaneous nodule submitted for histopathologic examination and culture. The microbiology laboratory staff should be alerted to the diagnostic possibilities so that appropriate cultural and incubation techniques, procedures, and precautions can be initiated. Provision of a correct microbiologic diagnosis and institution of appropriate antimicrobial therapy will result in a complete cure in almost all instances. Adjunctive surgical debridement may be required for certain organisms such as Nocardia or Mycobacterium chelonae.
Collapse
Affiliation(s)
- R A Smego
- Department of Infectious Diseases and Clinical Microbiology, University of the Witwatersrand, Faculty of Health Sciences, Johannesburg, Republic of South Africa
| | | | | |
Collapse
|
15
|
Abstract
Histoplasmosis remains a common infection in endemic regions of North America and Latin America, causing a broad spectrum of clinical findings. Experience during recurrent outbreaks in Indianapolis has shown the importance of immunosuppressive conditions including the acquired immunodeficiency syndrome (AIDS) as a risk factor for disseminated disease and expanded our knowledge of the common clinical manifestations. Pericarditis, rheumatologic manifestations, esophageal compression, and sarcoidlike manifestations were found to be relatively common findings in histoplasmosis. These studies have established the useful role of serologic testing and have led to the discovery of antigen testing for diagnosis of histoplasmosis. This experience also has offered the opportunity to examine the outcome of treatment in persons with AIDS, contributing to studies that have found itraconazole to be an excellent alternative to amphotericin B in persons with mild or moderately severe infection.
Collapse
Affiliation(s)
- J Wheat
- Division of Infectious Diseases, Indiana University School of Medicine, Indianapolis, USA.
| |
Collapse
|
16
|
English JC, Laws RA, Keough GC, Wilde JL, Foley JP, Elston DM. Dermatoses of the glans penis and prepuce. J Am Acad Dermatol 1997; 37:1-24; quiz 25-6. [PMID: 9216519 DOI: 10.1016/s0190-9622(97)70207-x] [Citation(s) in RCA: 90] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
A wide range of infectious, neoplastic, and inflammatory dermatoses can affect the glans penis or prepuce. Some are unique to the genitalia. Other more common dermatoses may have a unique appearance when they involve genital skin and mucosa. A thorough understanding of regional anatomy and a systematic diagnostic approach are helpful in the management of a refractory penile dermatosis. We review embryology and regional anatomy, drug-induced eruptions, allergic and irritant dermatitis, infection, neoplasia, and traumatic and inflammatory dermatoses as they relate to the glans and prepuce. Our discussion focuses on the clinical features, office laboratory studies, and histopathologic findings that assist in diagnosis and treatment.
Collapse
Affiliation(s)
- J C English
- Department of Dermatology, Brooke Army Medical Center, Texas, USA
| | | | | | | | | | | |
Collapse
|
17
|
Abstract
A case is presented of a woman with a long history of sarcoidosis who developed diffuse histoplasmosis. Although association between these two entities has been described before, there are only a few case reports of histoplasmosis among sarcoid patients. Diagnosis was finally established by bone marrow biopsy which saved the patient's life.
Collapse
Affiliation(s)
- P S Badesha
- Department of Medicine, Wright State University, Dayton, Ohio, USA
| | | | | |
Collapse
|
18
|
Randhawa HS, Chaturvedi S, Khan ZU, Chaturvedi VP, Jain SK, Jain RC, Bazaz-Malik G. Epididymal histoplasmosis diagnosed by isolation of Histoplasma capsulatum from semen. Mycopathologia 1995; 131:173-7. [PMID: 8587584 DOI: 10.1007/bf01102897] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
An autochthonous case of epididymal histoplasmosis masquerading as tuberculosis in a 55-year-old male patient is reported from India. It was diagnosed by culture of Histoplasma capsulatum from semen and by demonstration of the fungus upon re-examination of epididymal biopsy sections previously misinterpreted as tuberculous granuloma. The patient's main complaints were painful epididymal swelling, occasional fever and cough. He was treated successfully by excision of epididymis and vas deferens combined with amphotericin B therapy. This is believed to be the first case of epididymal histoplasmosis to be reported outside the American continent and the fourth of its type reported in the English literature. The case is also noteworthy in that H. capsulatum was isolated for the first time from semen, and it underlines the importance of mycological culture of semen specimens for diagnosis of genitourinary infections of obscure etiology.
Collapse
Affiliation(s)
- H S Randhawa
- Department of Medical Mycology, Vallabhbhai Patel Chest Institute, University of Delhi, India
| | | | | | | | | | | | | |
Collapse
|
19
|
Krunic A, Calonje E, Jeftovic D, Berger S, Milinkovic M, Lausevic Z, Martinovic N, Kokai D. Primary localized cutaneous histoplasmosis in a patient with acquired immunodeficiency syndrome. Int J Dermatol 1995; 34:558-62. [PMID: 7591438 DOI: 10.1111/j.1365-4362.1995.tb02954.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- A Krunic
- Department of Dermatology, Medical School, University of Belgrade, Yugoslavia
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Ohnishi K, Nagai Y, Okada K, Ishikawa O, Miyachi Y. Primary cutaneous histoplasmosis in papuloerythroderma (Ofuji). J Dermatol 1994; 21:586-9. [PMID: 7962957 DOI: 10.1111/j.1346-8138.1994.tb01798.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We report the first Japanese patient with primary cutaneous histoplasmosis who was infected inside Japan. He was not an immunocompromised host but his cutaneous lesions developed on preexisting papuloerythroderma (Ofuji). The long-term topical corticosteroid treatment for papuloerythroderma, which could have suppressed the local immunological defence system of the skin, might have been responsible for the histoplasma infection in the present case.
Collapse
Affiliation(s)
- K Ohnishi
- Department of Dermatology, Gunma University School of Medicine, Japan
| | | | | | | | | |
Collapse
|
21
|
Affiliation(s)
- G J Wise
- Division of Urology, Maimonides Medical Center, Brooklyn, New York
| | | |
Collapse
|
22
|
Abstract
Histoplasmosis is a common cause of systemic mycosis in endemic areas of the United States. Genitourinary and cutaneous involvement with this dimorphous fungus is rare. We report a case of disseminated histoplasmosis associated with nonpainful ulcerative lesions of the glans and shaft of the penis.
Collapse
Affiliation(s)
- B Preminger
- Department of Surgery, Maimonides Medical Center, Brooklyn, New York
| | | | | | | | | | | |
Collapse
|
23
|
Wise GJ. FUNGAL INFECTIONS OF THE EXTERNAL GENITALIA. Urol Clin North Am 1992. [DOI: 10.1016/s0094-0143(21)00850-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
24
|
Cohen PR, Held JL, Grossman ME, Ross MJ, Silvers DN. Disseminated histoplasmosis presenting as an ulcerated verrucous plaque in a human immunodeficiency virus-infected man. Report of a case possibly involving human-to-human transmission of histoplasmosis. Int J Dermatol 1991; 30:104-8. [PMID: 2001898 DOI: 10.1111/j.1365-4362.1991.tb04220.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A 46-year-old homosexual man with disseminated histoplasmosis and human immunodeficiency virus (HIV) infection had a histoplasmosis-related ulcerated verrucous plaque above his left upper lip; systemic and cutaneous disease manifestations of histoplasmosis resolved with daily ketoconazole therapy. Disseminated histoplasmosis, with similar cutaneous features, also was present in his HIV-seropositive male sexual partner. The possibility of human-to-human transmission of histoplasmosis between these patients is considered and the skin lesions of systemic fungal infections in HIV-infected patients are reviewed.
Collapse
Affiliation(s)
- P R Cohen
- Department of Dermatology, College of Physicians and Surgeons of Columbia University, New York, New York
| | | | | | | | | |
Collapse
|
25
|
Cohen PR, Bank DE, Silvers DN, Grossman ME. Cutaneous lesions of disseminated histoplasmosis in human immunodeficiency virus-infected patients. J Am Acad Dermatol 1990; 23:422-8. [PMID: 2212140 DOI: 10.1016/0190-9622(90)70235-a] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Disseminated histoplasmosis is being diagnosed more frequently in persons infected with the human immunodeficiency virus and is often the initial manifestation of the acquired immunodeficiency syndrome (AIDS). Disease-related cutaneous features of HIV-associated disseminated histoplasmosis are defined as mucocutaneous lesions from which fungal organisms were either cultured or demonstrated histopathologically. We report four HIV-seropositive patients with disseminated histoplasmosis who had culture-positive skin or oral lesions of histoplasmosis and review the specific cutaneous manifestations of HIV-associated disseminated histoplasmosis. Including our patients, disease-related skin and/or mucosal lesions were present in 11% of patients (26% of 239) with HIV-associated disseminated histoplasmosis. The possibility of disseminated histoplasmosis should be considered in all HIV-infected persons and in persons with AIDS risk factors who have fever, weight loss, hepatosplenomegaly, and new cutaneous lesions. An early skin or mucosal biopsy specimen for crushed tissue preparation, histologic evaluation, and fungal culture is a simple, rapid diagnostic procedure.
Collapse
Affiliation(s)
- P R Cohen
- Department of Dermatology, College of Physicians and Surgeons of Columbia University, New York, New York
| | | | | | | |
Collapse
|
26
|
|
27
|
|
28
|
McGregor JA, Kleinschmidt-DeMasters BK, Ogle J. Meningoencephalitis caused by Histoplasma capsulatum complicating pregnancy. Am J Obstet Gynecol 1986; 154:925-31. [PMID: 3963087 DOI: 10.1016/0002-9378(86)90488-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We report what appears to be the first established case of disseminated histoplasmosis in pregnancy. Involvement of the central nervous system made treatment difficult, and the course of disease required iatrogenic preterm delivery of an uninfected fetus. Aspects of pathogenesis, diagnosis, interaction with pregnancy, and treatment for this common infection, hitherto unreported in pregnancy, are presented.
Collapse
|
29
|
Abstract
A recurrence of cryptococcosis sixteen years after the primary infection as a penile ulcer is reported. The clinical manifestations of genitourinary and skin involvement by cryptococci are discussed. The epidemiology, pathogenesis, diagnosis, and treatment of penile mycotic infections are reviewed.
Collapse
|
30
|
Abstract
We report 2 cases of epididymal histoplasmosis. In 1 patient an epididymal abscess was the sole manifestation of histoplasmosis and in the other an epididymal abscess occurred with paratracheal lymphadenopathy. Although uncommon histoplasmosis can cause symptomatic genitourinary tract disease and must be differentiated from tuberculosis, tumors and other fungal and bacterial infections.
Collapse
|
31
|
Davies SF, Khan M, Sarosi GA. Disseminated histoplasmosis in immunologically suppressed patients. Occurrence in a nonendemic area. Am J Med 1978; 64:94-100. [PMID: 623139 DOI: 10.1016/0002-9343(78)90183-3] [Citation(s) in RCA: 97] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
32
|
Reimann HA. Infectious diseases: annual review of significant publications. Postgrad Med J 1974; 50:485-96. [PMID: 4377174 PMCID: PMC2495653 DOI: 10.1136/pgmj.50.586.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|