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At least 757 records · Page 42Linked to original sources
PubMed1999

Histoplasmosis and Paracoccidioidomycosis in northwestern Argentina III. Epidemiological survey in Vipos, La Toma, and Choromoro - Trancas, Tucumán, Argentina.

The present work was undertaken to obtain epidemiological data on the extent and distribution of Histoplasma capsulatum var. capsulatum and Paracoccidiodes brasiliensis diseases in the Vipos, La Toma and Choromoro areas. Skin test surveys with histoplasmin and paracoccidioidin were carried out in the permanent human population of those localities. Mycological sputum studies and serological tests were performed to skin test reactors to determine if there were signs or symptoms of active mycotic disease. La Toma and Choromoro are highly prevalent areas of histoplasmosis (>30% the histoplasmin positive individuals) whereas Vipos can be relatively considered a highly prevalent area (between 20-30% the histoplasmin reactors) according to the normally accepted range used to define an endemic disease [2]. Early Histoplasma capsulatum infection (<10 years old) is reported for Vipos and Choromoro. La Toma has the highest rate of previous exposure to P. brasiliensis detected in the studied area (10.2%). Vipos residents are not infected with P. brasiliensis.

Adolescent↗
PubMed1995

Immunophenotyping in presumed ocular histoplasmosis like retinopathy.

Four cases of presumed ocular histoplasmosis like retinopathy are presented. A detailed immunological assessment was carried out on the patients and a control group: lymphocyte immunophenotyping; flow cytometric analysis; HLA typing and T cell receptor variable region (TCR V region) expression were assessed. Analysis of TCR V region expression revealed no significant preferential expression. HLA typing also failed to reveal any links. All lymphocyte markers analysed were unremarkable, with the exception of CD38 which was significantly raised compared with controls (p < 0.01). This finding was confirmed by the use of two different CD38-specific monoclonal antibodies. The raised CD38 in our cases was shown to be persistent when the patients were retested after an interval of several months. Significantly, this may correlate with poor T cell function, as in Common Variable Immunodeficiency, making these patients more susceptible to various stimuli.

ADP-ribosyl Cyclase↗
PubMed1997

Cutaneous disseminated histoplasmosis in AIDS patients in south Florida.

BACKGROUND: Histoplasma capsulatum is a dimorphic pathogenic fungus endemic to the Mississippi and Ohio river valleys. In the immunocompetent it causes a self-limited disease, but in the immunocompromised may lead to disseminated disease (disseminated histoplasmosis (DH)). It is one of the opportunistic infections which defines the acquired immunodeficiency syndrome (AIDS) and is rarely encountered outside endemic regions. METHODS: Clinical, laboratory, and histologic information concerning seven patients with DH and AIDS in South Florida was recorded. RESULTS: We report seven cases of DH with mucocutaneous lesions in patients infected with the human immunodeficiency virus (HIV). All patients had markedly depressed CD4 counts of less than 40 cells/mm3, and only two had traveled to endemic areas. Two out of the seven patients were diagnosed with HIV/AIDS at the time DH was identified. All of our patients had mucocutaneous lesions at the time of diagnosis, which clinically presented as a generalized papular eruption, ulcers, and erythematous scaly plaques. CONCLUSIONS: Even in non-endemic regions, HIV-positive patients presenting with fever, chills, weight loss, hepatosplenomegaly, anemia, cough, lymphadenopathy, and mucocutaneous lesions should have an early skin biopsy specimen taken for mycologic tissue culture and histopathologic evaluation for disseminated fungal infections.

AIDS-Related Opportunistic Infections↗
PubMed1999

Case report. Successful therapy of disseminated histoplasmosis in AIDS with liposomal amphotericin B.

A 36-year-old HIV-infected male patient presented with relapsing fever episodes to 39 degrees C, night sweats and weight loss. Computerized tomography of the abdomen showed enlarged multiple lymph nodes. After surgical resection of multiple lymph nodes, disseminated infection with Histoplasma capsulatum was diagnosed. Amphotericin B desoxycholate was initiated for 24 days. Fourteen days after therapy was discontinued, the patient suffered similar symptoms again. Subsequent treatment with liposomal amphotericin B led to rapid improvement within 3 days. Upon discharge, maintenance therapy with 600-mg itraconazole capsules was initiated and decreased to 400-mg 14-days later. Itraconazole therapy was continued until the patient died more than 2 years later because of complications of the underlying disease. At autopsy there were no signs of histoplasmosis.

AIDS-Related Opportunistic Infections↗
PubMed2000

Case report. Primary cutaneous histoplasmosis in an immunosuppressed patient.

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.

Aged↗
PubMed2003

Colonic histoplasmosis in acquired immunodeficiency syndrome mimicking carcinoma.

Four cases of colonic histoplasmosis in patients with acquired immunodeficiency syndrome mimicking other diseases, primarily colonic adenocarcinoma, are presented. This topic has been extensively discussed from the medical and radiologic standpoint, but very few publications are found in the pathology literature. Emphasis is made on the discussion of the clinical manifestations; endoscopic, radiologic, and pathologic characteristics; differential diagnosis; and treatment.

AIDS-Related Opportunistic Infections↗
PubMed1999

Histoplasmosis of the wrist.

We present a case of synovitis of the wrist due to histoplasmosis, diagnosed only after extensive surgery and culturing. Treatment with amphotericin B in combination with radical surgery was effective in curing the disease. This manifestation was probably an exacerbation of a latent chronic infection with Histoplasma capsulatum, although it was unclear why the exacerbation occurred. Synovitis resistant to treatment should be assessed with great care, especially in view of the growing number of immunocompromised patients. Close collaboration between surgeon, rheumatologist, pathologist and microbiologist is paramount in such cases.

Aged↗
PubMed2004

[Presumed ocular histoplasmosis syndrome (POHS) in a non-endemic area].

BACKGROUND: POHS is a chorioretinal disease rarely occurring in non-endemic areas. METHODS: We present the case of a 35-year old male patient with symptoms of dry eyes, but subjectively no other ocular complaints. However, visual acuity of the right eye was 20/20, but only 20/200 in the left eye. RESULTS: On fundoscopic examination both eyes showed alterations consistent with all four typical features of presumed ocular histoplasmosis syndrome. In both eyes in the mid-periphery punched-out chorioretinal spots were found, an extensive peripapillary atrophy and peripheral linear chorioretinal streaks were seen. Moreover, in the left eye an atrophic macular scar existed, presumably due to subretinal neovascularisation. The macula of the right eye was normal, serology testing for Histoplasma capsulatum negative. CONCLUSIONS: As the patient had never travelled to endemic areas such as the USA but exhibited all features of POHS, the case shows that POHS may also occur in European, non-endemic areas. This further supports the theory that other factors play a role in the etiopathology of this syndrome.

Adult↗
PubMed1980

Needle biopsy of histoplasmosis.

A case of histoplasmosis, simulating a bronchogenic carcinoma, was needle biopsied. "Histoplasma capsulatum" organisms were found in great numbers. Needle biopsy established an accurate diagnosis making an exploratory thoracotomy unnecessary and preventing the patient from an already planned lobectomy. Specific treatment with Amphotericin B healed the lesion.

Acute Disease↗
PubMed1994

[Disseminated histoplasmosis in AIDS].

A 41-year-old man infected with HIV-1 developed fever up to 39.8 degrees C together with nonproductive cough and dyspnoea. Lactate dehydrogenase concentration rose from a level of 998 U/l to 6307 U/l. As pneumocystis carinii pneumonia was at first suspected he was treated with co-trimoxazole (1600 mg sulfamethoxazole and 320 mg trimethoprim, four times daily). But the symptoms did not abate. Bone-marrow puncture revealed numerous macrophages containing ovoid inclusions typical of Histoplasma capsulatum varietas capsulatum. The diagnosis of disseminated histoplasmosis was confirmed by culture and serologically by an increase in Histoplasma polysaccharide antigen. On treatment with amphotericin B (at first 10 mg, then 50 mg daily for 4 weeks) the symptoms regressed within a few days. After the concentrations of lactate dehydrogenase and Histoplasma antigen had become normal again, maintenance treatment was changed to itraconazole (200 mg twice daily), after a total amphotericin B dose of 1150 mg. The patient has remained free of recurrence.

AIDS-Related Opportunistic Infections↗
PubMed1993

[Histoplasmosis of the skin as an initial opportunistic infection in AIDS].

A 55-year-old homosexual Indonesian (last stay in Indonesia 2 years previously), known to be HIV positive since 1986, developed desquamating, in part ulcerating, skin eruption over the face and shoulder region. On admission his temperature was 38.2 degrees C, erythrocyte sedimentation rate 72/95 mm, white cell count 3.100/microliters, and the CD4 cell count 30/microliters. Examination of lung, oesophagus, stomach, duodenum and colon for possible opportunistic infections was negative. Fundoscopy revealed an infiltrate in the right eye with destruction of the vitreous. Skin biopsy suggested histoplasmosis, confirmed by culturing H. capsulatum varietas capsulatum. It is likely that this was the reactivation of a latent, previously symptom-free infection, in this case the first opportunistic infection in the presence of AIDS. For 30 days he received infusions of amphotericin B (initially 0.1 mg/kg daily, after the 5th day 0.5 mg/kg), resulting in rapid healing of the skin lesions. Subsequently he has received (for 6 months so far) itraconazole, 400 mg daily, without further complications.

AIDS-Related Opportunistic Infections↗
PubMed1980

[African histoplasmosis of the lung (author's transl)].

Lung resection showing giant cell (African) histoplasmosis was performed because of suspected lung tumour in a patient who had lived mainly in West Africa. A primary focus or signs of localisation in other organs were suspected radiographically in the maxilla and in the skeleton. However, they could not be confirmed as the patient declined further investigations for diagnosis and therapy.

Adult↗
PubMed1982

African histoplasmosis presenting as a facial tumour in a child.

A case of African histoplasmosis with an unusual presentation in a 13-year old Nigerian school boy is described. The diagnosis was established by histological examination of biopsy material and treatment with amphotericin B was successfully undertaken.

Adolescent↗
PubMedDate not supplied

Photodynamic therapy for subfoveal classic choroidal neovascularization related to punctate inner choroidopathy (PIC) or presumed ocular histoplasmosis-like syndrome (POHS-like).

PURPOSE: To evaluate the safety and efficacy of photodynamic therapy with verteporfin (PDT) for subfoveal classic choroidal neovascularization (CNV) related to punctate inner choroidopathy (PIC) or presumed ocular histoplasmosis-like syndrome (POHS-like). METHODS: Retrospective review of 16 eyes from 14 patients with subfoveal classic CNV associated with PIC or POHS-like and treated with PDT. RESULTS: The mean visual acuity increased from 4.5/10 (range: 1/10-9/10) to 7/10 (range: 2/10-10/10) after a mean follow-up of 21 months (range: 8-32 months) and a mean number of 2 PDT (range: 1-6). Visual acuity remained stable or improved in 13 of the 16 eyes (81%) and decreased in three. CONCLUSION: This nearly two-year follow-up study suggests that PDT could be helpful for patients with subfoveal classic CNV related to PIC or POHS-like.

Adolescent↗
PubMed2000

Granulomatous skin lesions due to histoplasmosis in a badger (Meles meles) in Austria.

We describe the first case of histoplasmosis due to infection with Histoplasma capsulatum var. capsulatum in a wild badger (Meles meles) in Austria. Diagnosis was established by histopathological and immunohistochemical characterization of yeast forms in skin lesions and lymph nodes. Although Austria has yet to be regarded as an endemic region for H. capsulatum, infections of animals and humans exposed to contaminated soil cannot be excluded.

Animals↗
PubMed2000

Amphotericin B combined with itraconazole or fluconazole for treatment of histoplasmosis.

To investigate the efficacy of combined treatment with fluconazole (Flu) and amphotericin B (AmB) for Histoplasma capsulatum meningitis, MICs were determined for 10 clinical isolates, following National Committee for Clinical Laboratory Standards guidelines. Weak synergy was observed for 6 of the 10 isolates. For the in vivo models, mice either were sham treated or were given Flu (75 mg/kg/day), AmB (2 mg/kg every other day), itraconazole (Itra; 75 mg/kg/day), AmB+Flu, or AmB+Itra. Following infection with 5x105 yeasts, Flu antagonized AmB's reduction of fungal burden without reducing its effect on survival. When in vivo antagonism was reproduced following infection with 1x104 yeasts, a higher fungal burden was observed in the lungs. Itra had no effect on AmB's activity and was more effective than Flu for clearance of fungal burden. These findings caution against use of AmB+Flu for treatment of histoplasmosis, but studies of the effect of treatment on the fungal burden in the brain are needed to assess combination therapy for meningitis.

Amphotericin B↗
PubMed2001

Emergence of resistance to fluconazole as a cause of failure during treatment of histoplasmosis in patients with acquired immunodeficiency disease syndrome.

In sequential clinical trials of treatment for histoplasmosis in patients with acquired immunodeficiency syndrome, therapy with fluconazole failed in a higher proportion of patients than did therapy with itraconazole. To determine the cause for failure with fluconazole, antifungal susceptibility testing that used modified National Committee on Clinical Laboratory Standards procedures was performed on all baseline and failure isolates. Failure occurred more frequently in patients with baseline isolates with fluconazole minimum inhibitory concentrations (MICs) > or =5 microg/mL versus lower MICs; 29% versus 3%, respectively. There was at least a 4-fold increase in fluconazole MIC in the isolates from 10 (59%) of 17 patients for whom paired pretreatment and failure or relapse isolates were available. Cross-resistance to itraconazole was not seen. In conclusion, fluconazole is less active than itraconazole for Histoplasma capsulatum and induces resistance during therapy, which accounted for treatment failure in some patients.

AIDS-Related Opportunistic Infections↗