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At least 883 records · Page 49Linked to original sources
PubMedDate not supplied

[Histoplasmosis in immunodepressed patients: study of 18 cases seen in Uberlândia, MG].

The diagnosis of histoplasmosis was made by isolation of Histoplasma capsulatum from cerebrospinal fluid (CSF), blood and bone marrow or by histopathologic (biopsy or post mortem) examination. The mean age of the patients was 35.8 years; 13 patients were male (72.2%). The disease was disseminated, with the following distribution:skin (38.8%), bone marrow (27.7%), nasopharyngeal mucosa (22.2%), lungs (22.2%), colon (11.1%), central nervous system (5.5%) and esophagus (5.5%). Adenomegaly (50%), hepatomegaly (77.7%) and splenomegaly (61.1%) were frequently seen. The most common hematologic abnormality was pancytopenia (33.3%) of the patients. Eleven patients were treated, 9 with amphotericin B and 2 with itraconazole. Eight had good clinical improvement and all of them were given amphotericin B or a triazolic as maintenance therapy. This study emphasize the importance of this mycosis in immunodepressed patients, specially AIDS patients, in whom the infection tends to invade the macrophagic-lymphoid system and preferentially the cutaneous tegument.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Histopathological and immunohistochemical characteristics of cutaneous and oral mucosa lesions in disseminated histoplasmosis associated with acquired immunodeficiency syndrome (AIDS)].

Biopsy specimens of the skin and oral mucosa from twenty-five patients bearing the disseminated form of histoplasmosis (H. capsulatum) associated with AIDS (acquired immunodeficiency syndrome) were studied by histologic and immunohistochemistry techniques. Histologically, the skin lesions showed four different patterns: diffuse macrophage, granulomatous, vasculitic with leukocytoclastic and scarce inflammatory reaction. The cell markers for macrophages, lymphocytes B and T and H. capsulatum revealed CD68, UCHL-1 and L26 associated with variable amounts of fungi.

AIDS-Related Opportunistic Infections↗
PubMed2004

Histoplasmosis presenting as addisonian crisis in an immunocompetent host.

A 71-year-old man with presumptively treated pulmonary tuberculosis ten years earlier and previous alcoholism presented with adrenal insufficiency. HIV serology was negative. A computerized tomography scan of the abdomen showed enlarged right adrenal. He recovered after emergency treatment with hydrocortisone IV. Right adrenalectomy was performed. Histoplasmosis was diagnosed and the patient was treated with itraconazole, corticosteroid replacement, and discharged with good health.

Addison Disease↗
PubMedDate not supplied

[Disseminated histoplasmosis in Rio Grande do Sul].

This report describes epidemiological, clinical and laboratorial aspects of 111 cases of disseminated histoplasmosis from Rio Grande do Sul over a 25-year period (1977-2002). AIDS and non-AIDS patients were analyzed was the predisposing disease in 63.1% of the patients. In both groups there were mostly men, without evidence of exposure to microfoci contaminated with Histoplasma capsulatum. The main clinical features were systemic (fever and weight loss were present in 97.1 and 92.7% of AIDS and non-AIDS cases), followed by respiratory and mucocutaneous manifestations. Seromycology (positive in 54.5% and 65.3% in AIDS and non-AIDS cases) was useful as a screening test. The high index of cutaneous involvement in AIDS patients (44.3%) compared with North American reports (p <0.01) suggests that different strains of Histoplasma capsulatum may induce different clinical manifestations of the same disease.

AIDS-Related Opportunistic Infections↗
PubMed2001

Histoplasmosis as a late infectious complication following heart transplantation in a patient with Chagas' disease.

Infectious complications following heart transplantation are an important cause of morbidity and mortality. Generally, bacterial infections are predominant; however, fungal infections can be responsible for up to 25% of infectious events. We report the case of a patient who presented with histoplasmosis as an infectious complication five years after heart transplantation due to a chagasic cardiopathy. This association has rarely been reported in the international literature.

Adult↗
PubMed1986

Immunofluorescent detection of Histoplasma capsulatum in primate experimental ocular histoplasmosis.

We have developed a polyclonal anti-Histoplasma capsulatum antibody to detect H. capsulatum antigens in ocular tissue. Antibodies were specific for H. capsulatum as determined by enzyme linked immunosorbent assay and immunoprecipitation. A total of 21 choroidal histoplasmic lesions in 4 primate eyes (Macaca speciosa and Macaca mulatta), taken at various times from 14 to 60 days after the internal carotid artery injection of yeast phase organisms, were evaluated. Using an indirect immunofluorescent technique, these antibodies stained yeast phase organisms within acute choroidal lesions at 14 days after infection. By 60 days intact organisms were no longer detected; occasional cells, however, contained intracellular inclusions that stained with these antibodies. Although yeast phase organisms are rapidly cleared from the primate choroid, these data indicate that residual H. capsulatum antigens may remain in choroidal lesions after the acute infectious stage. These findings are consistent with the hypothesis that H. capsulatum antigens play a role in the immunologic reactivation of atrophic choroidal scars in ocular histoplasmosis.

Animals↗
PubMed2006

B cells and CD4-CD8- T cells are key regulators of the severity of reactivation histoplasmosis.

The fungus, Histoplasma capsulatum, produces a persistent infection. Reactivation histoplasmosis is largely a result of impaired immunity, but the perturbations associated with escape of the fungus from host defenses remain ill-defined. We analyzed a murine model of reactivation to elucidate the host defects that permit reactivation. C57BL/6 mice were infected intranasally and, 42 days later, they were depleted of CD4(+) and CD8(+) cells. Elimination of these cells, but not either alone, produced a persistent infection over several weeks. Neutralization of IFN-gamma, TNF-alpha, or both did not induce reactivation. Endogenous IL-10 exacerbated reactivation. Depletion of T cells in B cell(-/-) mice induced a markedly higher burden in organs when compared with wild type. However, the infection remained persistent. Elimination of CD4(+) cells alone or neutralization of cytokines increased the fungal load. The persistent infection was not dependent on gammadelta T cells or NK cells. Elimination of Thy-1.2(+) cells in mice given mAb to CD4 and CD8 transformed reactivation into a progressive, lethal infection in B cell(-/-) and wild-type mice, but the tempo of progression was accelerated in the former. The data reveal the complex control by the host to prevent reactivation of this fungus.

Animals↗
PubMed2002

Hemophagocytosis in a patient with chronic lymphocytic leukemia and histoplasmosis.

We present a case of hemophagocytosis in the setting of a disseminated Histoplasma infection in a patient with B-cell chronic lymphocytic leukemia (CLL). A 68-year-old man with CLL presented with progressive pancytopenia and fevers after therapy with cyclophosphamide and fludarabine phosphate. Extensive evaluation for a source of infection revealed a pulmonary nodule. A biopsy specimen taken from the nodule showed granulomas containing Histoplasma organisms. A bone marrow biopsy specimen demonstrated disseminated histoplasmosis and intense hemophagocytosis. Antifungal therapy with amphotericin B was initiated, and the fevers and cytopenias resolved. Hemophagocytic syndrome is an uncommon condition with many origins. It is characterized by a proliferation of histiocytes with phagocytosis of formed elements of blood. Clinical manifestations include signs and symptoms of immune activation and decreased peripheral blood cell counts. This condition is often underdiagnosed because clinicians are unfamiliar with it.

Aged↗
PubMed1977

Occurrence of Histoplasma capsulatum Darling, 1906 in Israel, with a review of the current status of histoplasmosis in the Middle East.

The isolation of Histoplasma capsulatum from a bat cave in the Galilee region of Israel is reported along with the discovery of a bat (Myotis myotis) infected by H. capsulatum. Soils collected in avian and chiropteran habitats throughout Israel also yielded the following fungi of medical interest: Arthroderma quadrifidum, A. tuberculatum, Candida parapsilosis, Chrysosporium indicum, C. keratinophilum, C. tropicum, Cryptococcus neoformans, Ctenomyces serratus, Microsporum gypseum, and Petriellidium boydii. All available reports concerning the occurrence of H. capsulatum and histoplasmosis in the Middle East are critically reviewed.

Animals↗
PubMed1978

An epidemic of histoplasmosis on the Isthmus of Panama.

Forty-seven men on the Isthmus of Panama were exposed to histoplasmosis in an old bunker inhabited by bats. The resulting epidemic was studied with serial clinical, serological, and radiological examinations. Thirty-seven (78.7%) of the men showed serological evidence of infection and 26 (70.3%) had symptoms. Incubation periods ranged from 4 to 30 days. A general relationship between severity of illness and degree of exposure was noted. The agar gel diffusion test for precipitin antibodies was more sensitive than the complement-fixation test or slide test in detecting infection with Histoplasma capsulatum. Decontamination procedures and environmental studies are described.

Amphotericin B↗
PubMedDate not supplied

Histoplasmosis infection in two cats from California.

Systemic mycotic infections are typically localized to specific geographic regions of the country, because the organisms involved have certain environmental requirements for growth. Suspicion of infection relies on travel to or residence in recognized endemic regions. This report describes infection with histoplasmosis in two indoor cats from central California, an area not considered to be endemic for the disease. Systemic mycotic infections should be considered as differential diagnoses in any cat with compatible clinical signs, regardless of travel history or residence, especially if the cat is presented within a recognized endemic region.

Animals↗
PubMed1976

Histoplasmosis: an outbreak occurring among young men who visited one cave.

Sixteen cases of acute benign inhalational histoplasmosis were investigated after an outbreak of the disease in a group visiting a cave. The diagnosis was confirmed in 13 patients by chest X-ray examination, histoplasmin skin testing and serological examination. An attempt to isolate the organism Histoplasma capsulatum was unsuccessful. The epidemiology and relationship of the disease to bat ecology is discussed.

Animals↗
PubMed1998

Cerebral histoplasmosis in an Australian patient with systemic lupus erythematosus.

A 39-year-old woman with systemic lupus erythematosus suffered a prolonged neurological illness associated with very low levels of glucose in her cerebrospinal fluid (CSF). Six months later, and after numerous CSF investigations, Histoplasma capsulatum was cultured. To our knowledge, this is the first report of cerebral histoplasmosis in Australia in a patient who is not HIV positive.

Adult↗
PubMed1981

A large urban outbreak of histoplasmosis: clinical features.

An outbreak of histoplasmosis estimated to involve more than 100,000 residents in Indianapolis, Indiana, occurred between September 1978 and August 1979. In the 435 cases evaluated, 52% of the patients were between 15 and 34 years old, and 63% were black. Fifteen patients died, and 46 progressive disseminated infection. Twenty-four patients had pericarditis, and 26 had rheumatologic syndromes. Unusual manifestations that occurred in 18 patients included esophageal and vocal cord ulcers, parotitis, adrenal insufficiency, uveitis, fibrosing mediastinitis, interstitial nephritis, intestinal lymphangiectasia, and epididymitis. The highest attack rate was in the central part of the city, which is a densely populated, disproportionately black section. The source of the outbreak has not been proved by positive culture results; two sites, however, were suspected on an epidemiologic basis.

Adolescent↗
PubMed1982

The diagnostic laboratory tests for histoplasmosis: analysis of experience in a large urban outbreak.

Of 495 patients reported in a large urban histoplasmosis outbreak, we studied 276 whose serologic tests were done in a single laboratory. Serologic test results were positive in 96% of these patients (compared with less than 5% of controls from an endemic area), cultures were positive in 22%, and special stains in 19%. The immunodiffusion test results were negative in 13% of patients who had positive findings by complement fixation, and 1% had positive results only by immunodiffusion. The complement fixation test was almost twice as sensitive as the immunodiffusion test in patients with subclinical infection. The serologic response differed significantly among the clinical syndromes with higher titers in cavitary and lower titers in disseminated disease. Factors associated with titers of 1:64 or greater to both antigens were black race and immunocompetence. High mycelial titers were also associated with more intense exposure, and high yeast titers were associated with age less than 36 years. No prognostic significance could be proved for fourfold titer rises or falls or persistence of precipitins.

Adolescent↗
PubMed1998

Disseminated histoplasmosis in an Atlantic bottlenose dolphin (Tursiops truncatus).

An approximately 37-yr-old female Atlantic bottlenose dolphin (Tursiops truncatus) died after a 4-mo illness characterized by intermittent anorexia, lethargy, mild neutrophilic leukocytosis, and mild nonregenerative anemia. At necropsy, the lungs were diffusely consolidated, and histopathology of the lungs revealed severe pneumonia with macrophages containing clusters of numerous yeast cells. Inflammatory lesions and yeast also were found in pulmonary, mediastinal, prescapular, and duodenal lymph nodes, spleen, liver, kidneys, urinary bladder, pancreas, right adrenal gland, and the pyloric stomach. Histomorphology, fungal culture, and polymerase chain reaction analysis indicated that the fungus was Histoplasma capsulatum var. capsulatum. This is the first report of histoplasmosis in a cetacean.

Animals↗
PubMed1976

Human histoplasmosis in Egypt-a preliminary serologic survey.

Thirteen (3%) of 441 patients had histoplasma antibodies in their sera when examined by the complement fixation test. The serologically histoplama positive individuals were all from a group of 266 patients complaining of chest disorders and from a sub-group of 147 such patients with positive findings on chest x-ray. There were no positives from a group of 175 patients complaining of fevers of unknown origin. The possibility of misdiagnosing lesions which may be due to histoplasmosis as being tuberculous must be considered indifferential diagnosis of pulmonary lesions.

Complement Fixation Tests↗