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At least 613 records · Page 34Linked to original sources
PubMed1989

Progressive disseminated histoplasmosis in acquired immune deficiency syndrome: presentation as a steroid-responsive dermatosis.

We describe a patient with acquired immune deficiency syndrome (AIDS) and disseminated histoplasmosis. He presented with a mild inflammatory dermatitis that improved with topical steroid treatment but was proven to be cutaneous histoplasmosis. The clinical presentations, diagnosis, histopathologic basis, and treatment of disseminated Histoplasma capsulatum in patients with AIDS are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Clinical review: progressive disseminated histoplasmosis in the AIDS patient.

Progressive disseminated histoplasmosis (PDH) has now been described in acquired immunodeficiency syndrome (AIDS) patients from areas both endemic and nonendemic for histoplasmosis. We review the clinical presentation, diagnosis, and therapy of PDH in patients with AIDS by comparing 64 patients from our series collected retrospectively from Houston and the surrounding area with the case summaries of 61 patients reported in the medical literature. PDH occurred as the first manifestation of AIDS half of the time. Fever, weight loss, enlargement of the liver, spleen, or lymph nodes, and anemia were the most common clinical symptoms and signs. Pulmonary symptoms were less common. The chest roentgenogram showed diffuse interstitial infiltrates in slightly more than half of the patients. Bone marrow biopsy and culture, examination and culture of pulmonary tissue and secretions, and blood culture were the most common initial means of establishing a diagnosis. Ketoconazole alone was ineffective in the majority of cases. Patients treated with amphotericin B (AMB) in a dose of at least 30 mg/kg experienced a significantly longer period of follow-up than those treated with less AMB. However, relapses were observed in four of 16 patients (25%) receiving at least 30 mg/kg of AMB followed by ketoconazole suppression. It appears that long-term suppression with 50 to 100 mg of AMB weekly, after completion of initial therapy, has the best chance of maintaining a satisfactory functional status.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Disseminated histoplasmosis caused by Histoplasma capsulatum and sarcoidosis. Apropos of a case].

Histoplasma capsulatum can, sometimes, simulate sarcoidosis, clinically and pathologically. A case is reported in which disseminated histoplasmosis is proved only by fungus granulomatous tissue. Another similar cases of the literature incite to propose the practice of special stains, above all Gomori-Grocott technical, before sarcoid-like lesions. Lesions pathogeny was discussed. In our case it's not possible to eliminate the role of primary sarcoidosis in disseminated histoplasmosis.

Adrenal Glands↗
PubMed1988

Disseminated histoplasmosis in dogs: 12 cases (1981-1986).

Diarrhea, intestinal blood loss, anemia, and lethargy were predominant clinical findings in 12 dogs with disseminated histoplasmosis. Young dogs were affected most commonly, with 6 dogs being 1 to 3 years old. A diagnosis of disseminated histoplasmosis was established on the basis of histologic or cytologic detection of Histoplasma organisms in intestinal or rectal mucosa in 7 dogs, in circulating leukocytes in 5 dogs, in bone marrow in 3 dogs, and in multiple tissues at necropsy in 1 dog (4 dogs had Histoplasma organisms detected in greater than 1 site). Anemia was detected in 10 dogs (PCV less than 20% in 3 dogs), and the anemia was inadequately regenerative or nonregenerative in 7. Hypoalbuminemia was detected in 9 dogs, and serum albumin concentrations were low (less than 1.0 g/dl) in 4 of the 9 dogs. Of 5 dogs treated with ketoconazole, 2 were in remission for greater than or equal to 1 year. Corticosteroid therapy may have exacerbated the disease in 4 dogs. Histoplasma infection of multiple organs was detected in 5 necropsied dogs.

Animals↗
PubMed1987

[Chronic disseminated histoplasmosis as an opportunistic infection].

Sixty four patients suffering a chronic disseminated histoplasmosis were studied with the aim of fingind if they had predisposing factors. Thirty cases (46.8%) presented the following predisposing conditions: long treatment with low doses of corticosteroids in 7, ethilic hepatopathy in 7, diabetes in 4, lymphoma in 3, epitheliomas in 3, epitheliomas and diabetes in 1, renal insufficiency in 1, toxic hepatitis in 1, radiations in 1, long treatment with psychotropics in 1 and primary combined immunodeficiency in 1. Only slight differences were detected between these two groups of patients; those who exhibited predisposing factors presented an increased number of clinical localizations, altered cell mediated immunological tests were more frequent as well as the number of patients with multiple relapses and deaths. Histoplasmosis was not the cause of death in any case. It is possible that if a more frequent aggressive exploration, as hepatic biopsy, would be done a higher number of patients with predisposing factors would have been demonstrated.

Chronic Disease↗
PubMed1988

Systemic talc granulomatosis associated with disseminated histoplasmosis in a drug abuser.

A 32-year-old intravenous drug abuser was found to have systemic talc granulomatosis and disseminated histoplasmosis. The clinicopathologic findings of this case support the hypothesis that the patient was predisposed to disseminated histoplasmosis by repeated intravenous talc administration. The effects of silica, a close relative of talc, on macrophages and the role of macrophages in recovery from Histoplasma capsulatum infection are described.

Adult↗
PubMed1988

An outbreak of acute histoplasmosis in a family.

Acute pulmonary histoplasmosis was diagnosed in three members of a New Mexico family that had recently attended a family reunion in Iowa. The treating physicians rapidly documented an outbreak of atypical pneumonia in the family. The clinical features and epidemiology of the outbreak suggest histoplasmosis was contracted during exposure in an abandoned barn. Fever, chills and myalgia were the most common symptoms; shortness of breath occurred frequently.

Adolescent↗
PubMed1986

Orbital histoplasmosis due to Histoplasma capsulatum var. duboisii: successful treatment with Septrin.

Four children with orbital histoplasmosis caused by Histoplasma capsulatum var. duboisii (one of whom had been unsuccessfully treated with amphotericin-B) were treated with a combination of trimethoprim and sulphamethoxazole (Septrin) and surgical drainage. All patients improved markedly during therapy with resolution of the lesions, and with no recurrence of infection in three patients, 1 year later. The fourth patient was lost to follow-up. Treatment was devoid of side effects. These findings clearly indicate that Septrin could be a safe alternative to amphotericin-B for the treatment of African histoplasmosis, especially in patients presenting with solitary or localized lesions.

Adolescent↗
PubMed1987

[African histoplasmosis in Mali].

Twenty-four cases of histoplasmosis have been diagnosed since 1945 in native Malians (20 cases) or Europeans living in Mali (4 cases). Seventeen cases have already been published and 7 other cases diagnosed recently in Bamako or Marseille are reported here. Mali is within the African histoplasmosis zone and the Kayes district may be a particularly endemic zone. The disease affected the skin (62 p. 100), lymph nodes (46 p. 100), bones (21 p. 100), gastrointestinal tract (26 p. 100) and lungs (4 p. 100). A rare lesion of the uvula is also reported. Direct fungal and histopathological techniques are the easiest and the most effective diagnostic investigations. All cases were due to Histoplasma duboisii. Amphotericin B was used in over 60 p. 100 of cases for an average period of 3 months. The total recovery rate was 66 p. 100.

Adolescent↗
PubMed1985

Ocular findings in patients with histoplasmosis.

Presumed ocular histoplasmosis syndrome is a multifocal choroiditis; it is not an uncommon cause of visual loss in patients who have positive cutaneous responses to histoplasmin tests. However, Histoplasma capsulatum infection is, most often, a pulmonary disease, or a systemically disseminated disorder, without visual symptoms. For this reason, a correspondence between the nonocular and ocular aspects of this disorder has been difficult to ascertain. In a series of eight patients with histoplasmosis, we found asymptomatic ocular lesions in six. We believe that the presence of asymptomatic lesions may have prevented earlier investigators from recognizing this correlation.

Adult↗
PubMed1985

Disseminated histoplasmosis in dialysis patients.

The unusual occurrence of disseminated histoplasmosis in two dialysis patients residing in a nonendemic area is described; one on chronic hemodialysis, the other on continuous ambulatory peritoneal dialysis (CAPD). They both presented with nonspecific febrile illness with splenomegaly and/or pancytopenia. Rapid diagnosis was made with bone marrow biopsies and cultures. In the second patient, peritonitis secondary to histoplasmosis was documented by culture of the dialysate and at autopsy. This is the first such description in a CAPD patient.

Aged↗
PubMed1967

Naturally occuring histoplasmosis in guinea pigs.

Histoplasmosis naturally occurring in laboratory guinea pigs is described in its clinical, necropsy, histological and mycological aspects.The animals if adult show a chronic disease with progressive emaciation and lameness of the hind legs. The young below three months of age died in 2 to 4 weeks presenting ruffled fur, great dorsal curvature and sometimes closed eyelids and catarrhal conjunctivitis. At necropsy the principal lesions were ulcerative gastritis, hemorrhagic and catarrhal enteritis, enlarged spleen and mesenteric lymph nodes. Sometimes the liver, lungs, mediastinal lymph nodes and other organs showed lesions. Histological and mycological demonstration of the fungus completed the diagnosis and the surviving animals were burned and sanitation measures instituted. Histological evidence of histoplasmosis in a cow's lung from the area from which the grass was obtained for the feeding of the guinea pigs suggests an epidemiological link. Efforts will be made to isolate and demonstrate H. capsulatum in wild animals on the same area.

Animal Diseases↗
PubMed1979

[Observation of a pulmonary histoplasmosis with Histoplasma capsulatum (author's transl)].

From an observation of pulmonary histoplasmosis with Histoplasma capsulatum in a Haiti woman living in France for 2 years, the authors recall the mycological and epidemiological data of this fungus as well as the main clinical radiological and biological signs of the disease. Because of its tendancy to dissemination, histoplasmosis can have a bad prognosis. It is difficult to diagnose in our countries and facing a chronic pulmonary form, a diagnosis of tuberculosis is often thought of. But its possibility is to be envisaged in case of a journey in countries of endemia, and the disease should be confirmed by: -- several samplings to trace the fungus, bringing the mycological prove of the disease; -- serum uses; -- modalities and difficulties of the treatment by Amphotericin B are also recalled.

Adult↗
PubMed1979

Histoplasmosis diffusion in Somalia: study of skin-test and serological survey.

Histoplasmin skin-test was applied to 1014 patients in two different parts of Somalia: in Mogadishu, an arid area, and in Jilib, a southern village on the banks of the Juba river. Among these patients only three gave areas of induration greater than 5 mm in diameter; all reactors were from Jilib. Results of a serological survey (latex-agglutination test) of histoplasmosis antibodies among 203 Somalian patients from three villages in river valleys are compared with the results of 171 inhabitants of the town of Mogadishu. Indirect agglutination antibody titers greater than or equal to 20 were found in 21.6% of the Mogadishu population as compared to 52.2% found in the river villages. In 96.2% of our cases in which the two tests were contemporarily used, the skin-test was completely negative despite high titres of positivity in the serological test. The results indicate the existence of founts of histoplasmosis infection in Somalia, particularly in humid areas bordering the rivers rather than in the surrounding arid semi-desert area characteristic of most of the country.

Female↗
PubMed1966

Histoplasmosis. A review of three cases studied in San Diego County.

Three cases of histoplasmosis, a disease seldom reported in California, were diagnosed clinically by the authors in San Diego County. It is probable that there is a higher incidence of this disease in California than is at present recognized. Travel history, histoplasmin skin testing and serologic studies for mycotic infection are important in the diagnosis. Cultures of secretions and biopsy material are of great value if positive; but negative cultures (at least in non-endemic areas) do not rule out the disease. Travel and migration to and from endemic areas present opportunities for this disease to constitute a diagnostic problem far from the geographic area in which the disease was acquired.Although usually benign, histoplasmosis may be severe in the acute state, may disseminate or may be chronically active and progressive. Amphotericin B is the only effective chemotherapeutic agent and it is usually reserved for these forms of the disease.

Amphotericin B↗
PubMed1983

Effect of silica on the susceptibility of mice to experimental histoplasmosis.

The role of macrophages in the innate immunity of mice to histoplasmosis was investigated using silica, which selectively inactivates macrophages. Mice given silica IV 1 day prior to challenge with live yeast cells of Histoplasma capsulatum were more susceptible to infection than were untreated controls. This increased susceptibility to Histoplasma was observed when mice were given silica at 1, 14, and 21 days prior to infection but not at 3 and 7 days. Silica treated mice that survived 30 days after challenge with a sublethal dose of Histoplasma had 23 times more viable organisms in their spleens than in those of untreated controls. The blastogenic response of spleen cells to concanavalin A and phytohemagglutinin was unaffected at 12 hr after silica injection but was significantly depressed between 1 and 21 days. In contrast, silica treatment did not affect the blastogenic response of spleen cells to lipopolysaccharide. Silica particles were cytotoxic for mouse peritoneal macrophages but not to lymphocytes in vitro. These results indicate that macrophages play an essential role in natural immunity to histoplasmosis.

Animals↗
PubMed1983

Presumed ocular histoplasmosis in Europe: a case report.

A case of presumed ocular histoplasmosis was diagnosed in a diabetic patient, and an angiographic study of the ocular lesions was carried out. Results of histoplasmin skin test and the specific complement fixation test were negative. The epidemiologic aspects of histoplasmosis in Europe are considered.

Complement Fixation Tests↗
PubMed1984

Esophageal obstruction caused by mediastinal histoplasmosis: beneficial results of operation.

A patient presented with progressive dysphagia and chest pain. Radiologic investigation showed extrinsic compression of the esophagus by enlarged, calcified, mediastinal lymph nodes. Immunologic studies suggested that this was due to previous histoplasmosis, currently inactive. The nodes were excised at thoracotomy, with complete relief of symptoms. Operative management was most appropriate because of the apparent inactivity of the infection, the severity and progressive nature of the symptoms, and the possible prophylaxis of mediastinal fibrosis, a well-documented complication of histoplasmosis.

Adult↗