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At least 919 records · Page 51Linked to original sources
PubMed1992

[Generalized histoplasmosis due to Histoplasma duboisii with mediastino-pulmonary infection. Cure after 15 months of treatment with ketoconazole].

We report a case of a young burkinabian, who presented with the disseminated african form of histoplasmosis, Histoplasma duboisii. There was pulmonary mediastinal disease with superficial lymphadenopathy and also hepatic involvement. The diagnosis was achieved by a histological examination of the peripheral glands and micrological examination of the expectorate. A clinical cure (despite the radiological persistence of enlarged but stable left hilar glands) with the follow up 10 months was achieved after 15 months of treatment with ketoconazole in a dose which was increased to 10 mg/kg/day.

Biopsy↗
PubMed2003

[A primary investigation on disseminated histoplasmosis in Hubei].

OBJECTIVE: To investigate the epidemiologic features of disseminated histoplasmosis (PDH) in Hubei province. METHODS: Bone marrow smears of 12 patients diagnosed as Kala-azer in Hubei province including 4 patients in Jingsan, 2 patients in Shashi and each 1 in Yichang, Jinmen, Zhongxiang, Luotian, Xianning and Guanghua respectively were re-examed under microscope. Peripheral blood and bone marrow smears of several patients were detected. After inoculated the bone marrow, peripheral blood, liver and spleen tissue of patients in MLI, the single colony was trans-inoculated in BHIB, SDA and CMA and incubated at 25 degrees C and 35 degrees C. Bone marrow, peripheral blood and bacterial fluid of yeast-phase Histoplasma capsulatum (H.cap) were injected into the abdominal cavity of Kunming mice and nude mice. When symptoms and signs developed, the spleen tissue was separated, then observed under microscope and cultured. Mycelium-phase and Yeast-phase H.cap were inoculated in urase and gelatin medium, then incubated at 25 degrees C and 35 degrees C. Histoplasmin was injected subcutaneously into patients, and then followed for 48 - 72 hours. Amphotericin B was selected to treat the PDH patients. RESULTS: Moriform cell cluster and sausage-shaped cell were not observed in mononuclear-macrophages in the bone marrow smears from 12 patients. Leishman-Donovan body was found only in one patient. There wasn't kinetoplast in the cellular plasm of spores in 11 patients and no transeptae was found. The reaction of H.cap to urease was positive and H.cap did not liquefy the gelatin. It appeared to be mycelium-phase at 25 degrees C but no penicillus and catenulate conidia was found. The characteristic denticle macroconidia was observed but produced red coloring matter. It also appeared to be yeast-phase at 35 degrees C. Yeast-phase spores were observed under microscope. No sausage-shaped spore and transeptae were identified. H.cap could be acquired in the spleen tissue in Kunming mice and nude mice. Bacterium forms, characteristics under microscope and biochemical reaction of mycelium-phase and yeast-phase H.cap were different from some other kinds of dimorphic fungi such as Penicillium marneffei and Histoplasm duboisii etc. CONCLUSION: There were scattered epidemics of PDH in Hubei province. The detection rate of PDH was higher in the southeast area then in the northwest area. The golden standards of clinic diagnosis were mycological culture and inoculation to animals. Amphotericin B was necommended as the first choice for treatment.

Adolescent↗
PubMed1992

Disseminated histoplasmosis.

We have presented the microbiology, pathogenesis, clinical presentation, diagnosis and treatment of disseminated histoplasmosis. Emphasis is presented on the manifestations in the HIV infected patient.

Histoplasmosis↗
PubMedDate not supplied

Choroidal neovascularization after laser in situ keratomileusis in a patient with presumed ocular histoplasmosis syndrome.

PURPOSE: A 44-year-old patient with presumed ocular histoplasmosis syndrome (POHS) who developed a choroidal neovascular membrane (CNV) after laser in situ keratomileusis (LASIK) surgery is presented. METHODS: A 44-year-old male patient with moderate myopia and POHS who underwent LASIK surgery complained of distorted vision after the procedure. He had a quiet POHS lesion prior to refractive surgery. Fundus examination and fluorescein angiography revealed subfoveal CNV after the LASIK surgery. He underwent 2 sessions of photodynamic therapy (PDT). RESULTS: Subfoveal CNV involuted after PDT and his vision improved from 20/300 to 20/25 at 13 months follow-up. CONCLUSIONS: CNV can be triggered by LASIK surgery in patients with POHS. Those patients should be made aware of and closely followed up postoperatively for this complication.

Adult↗
PubMed2005

Disseminated histoplasmosis.

OBJECTIVE: To study the clinical features and natural history of disseminated histoplasmosis(DH) in India. METHODS: We retrospectively analyzed the data obtained from the in-patient medical records of adults (age > 13 years) diagnosed to have DH during the period from January 1989 to December 1999. DH was diagnosed when histologically compatible intracellular organisms were present or Histoplasma capsulatum was obtained in culture from the extrapulmonary sites. RESULTS: Nineteen patients (18 male and 1 female) were diagnosed to have DH. Diabetes mellitus and HIV infection were the most common co-morbid conditions. Weight loss, fever and oropharyngeal ulcers were the commonest symptoms. Physical signs included hepatosplenomegaly, oropharyngeal ulcers and lymphadenopathy. The diagnosis was confirmed by histopathology and/or culture from the following sites: bone marrow, adrenal gland, lymph node, oropharyngeal ulcers, rectal mucosa and skin. Two patients were treated with Amphotericin B, 6 with various azoles and 3 had Amphotericin B followed by various azoles. Among the eleven treated, 7 were cured, 2 improved, 1 had a relapse and 1 patient died. CONCLUSION: DH is not uncommon in India and should be considered in the diagnosis of patients with prolonged fever, weight loss, oropharyngeal ulcers, hepatosplenomegaly, lymphadenopathy and adrenal enlargement. Correct diagnosis and treatment leads to a favourable outcome.

Adolescent↗
PubMedDate not supplied

[African histoplasmosis (Histoplasma capsulatum var. duboisii): a case report from Mali].

We report a case of disseminated African histoplasmosis with lymph node and digestive involvement in a 19-year-old man living in the Kayes district of Mali. The patient, HIV-seronegative and not otherwise immunocompromised, presented voluminous cervical and axillary adenopathies as well as retrosternal and mesenteric tumor lesions. Direct examination of biopsy tissue showed numerous specimens of Histoplasma capsulatum var. duboisii. Because direct fungal techniques are the easiest and the most effective method of diagnostic investigation, no cultures were performed. Intolerance to therapy with amphotericin b and ketoconazole led its rapid replacement by surgical treatment: partial excision of the abdominal lesions led to partial remission of the symptoms.

Adult↗
PubMedDate not supplied

Disseminated histoplasmosis diagnosed by percutaneous needle biopsy of a retroperitoneal lymph node. A case report.

A case of disseminated histoplasmosis diagnosed by percutaneous needle biopsy cytology is reported. The patient presented with fever and pancytopenia. Computed tomography (CT) revealed retroperitoneal lymphadenopathy. Cytology smears prepared from a CT-guided screw needle biopsy of one of the lymph nodes showed numerous histiocytes with intracytoplasmic yeast forms consistent with Histoplasma capsulatum. Fungal cultures prepared from additional needle biopsy material confirmed the diagnosis. This case illustrates the utility of needle biopsy in the evaluation of radiographically detected retroperitoneal lymphadenopathy and in the rapid diagnosis of infectious disease in certain clinical settings.

Biopsy, Needle↗
PubMedDate not supplied

[Histoplasmosis (infection with Histoplasma capsulatum, capsulatum variety)].

Histoplasmosis is an endemic mycosis in some regions in the US, but it can be more and more often imported to Europe. One of the clinical characters of the infection is the variety of shapes it can have, many similar to tuberculosis. It can be associated to HIV infection, being the most frequent mycosis in these patients in endemic regions. Diagnosis is based on evidence of mycotic filaments on microscopy or culture. Treatment consists of Amphotericin B and Itraconazole, the latter being also the foundation of primary and secondary prevention.

Amphotericin B↗
PubMed2006

Risk factors for death in acquired immunodeficiency syndrome-associated disseminated histoplasmosis.

We performed a retrospective study of 164 human immunodeficiency virus (HIV)-infected patients with disseminated histoplasmosis to identify the risk factors for death. Death occurred in 32% of the cases. Univariate analysis identified the following risk factors: diarrhea (odds ratio [OR] = 3.9, P = 0.001), neurologic manifestations (OR = 5.8, ; P = 0.001), hemoglobin level < 8.0g/dL (OR = 2.7, P = 0.004), urea level 2 times the normal upper limit (OR = 5.0, P < 0.001), creatinine level > 1.5 mg/dL (OR = 2.9, P = 0.005), aspartate aminotransferase (AST) level > 2.5 times the normal upper limit (OR = 3.1, P = 0.01), respiratory insufficiency (OR = 9.7, P < 0.001), sepsis (OR = 20.2, P < 0.001), and acute renal failure (OR = 2.5, P = 0.011). A hemoglobin level < 8.0 g/dL (OR = 3.8, P = 0.008), an AST level >or= 2.5 times the normal limit (OR = 1.0, P = 0.007), acute renal failure (OR = 2.96, P = 0.015), and respiratory insufficiency (OR = 12.2, P = 0.01) were independent risk factors for death.

AIDS-Related Opportunistic Infections↗
PubMed2006

[Pathological fracture revealing an osseous histoplasmosis. A case report on a 60-year patient].

The authors report a new case of African Histoplasmosis in a 60-year-old patient. It was an humeral localization revealing a pathological fracture which grew into an extension of osteolysis and a cutaneous fistulization likely to be a malignant bone tumor. The case has been diagnosed by surgical biopsy and histological analysis. Its antifungal treatment in progress resulted in the drainage of the out-flow that should permit the bone reconstruction by graft. The authors stress on the need to focus on this affection whenever, in a tropical area, one is faced with any chronic bone fistula that cannot positively be cured in spite of sound medical cares.

Bone Diseases↗
PubMedDate not supplied

[Histoplasmosis of the oral cavity].

Here is presented a case of a patient with histoplasmosis in the oral cavity a rare disease in our country and whose diagnosis is based upon epidemiological history, serological tests, cultures and hystological study of lymphatic nodes and the hard plate of the palate. Here we will expound upon clinical, diagnostical and therapeutic aspects as applied to our patient.

Histoplasma↗
PubMed1991

Disseminated histoplasmosis in a SIV-infected rhesus monkey.

Disseminated histoplasmosis due to Histoplasma capsulatum was diagnosed in a rhesus monkey inoculated with simian immunodeficiency virus (SIV). Immunohistochemical staining of tissues for viral core antigens revealed that those macrophages that expressed viral antigen contained few or no fungal organisms, while those that were filled with fungal organisms did not express viral antigen. This is a previously undocumented condition in a SIV-infected macaque, and suggests that SIV infection of individual macrophages is not the cause of macrophage dysfunction in SIV infections.

Animals↗
PubMedDate not supplied

Diagnosis of histoplasmosis in bronchoalveolar lavage fluid by intracytoplasmic localization of silver-positive yeast.

A case of histoplasmosis in a patient with acquired immunodeficiency syndrome is presented. Intracytoplasmic organisms were found in Diff-Quik- and Papanicolaou-stained bronchoalveolar lavage fluid sediment. Budding yeasts were found in the silver methenamine-stained material. It was initially thought that the yeasts might represent another infecting organism, especially in view of the patient's history of esophageal candidiasis. When the silver-stained material was counterstained with hematoxylin and eosin, simultaneous demonstration of cytologic detail and silver positivity showed that the silver-positive yeasts were intracellular, confirming that they were Histoplasma capsulatum. Counterstaining with hematoxylin and eosin allows localization of argyrophilic organisms to either intracellular or extracellular sites and is technically simple to perform. It is useful in acquired immunodeficiency syndrome patients and other immunocompromised hosts, in whom multiple organisms are often found.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Further comment on the importance of microscopy in clinical microbiology. The argument for the diagnosis of the skin manifestations of histoplasmosis and coccidioidomycosis].

This paper presents two interesting cases: a patient with cutaneous coccidioidomycosis, the first case in Romania, and a female patient with latent histoplasmosis with cutaneous manifestations, periodically reactivated during her pregnancies. The etiological diagnosis problems of these affections in relation with the degrees of competence of the clinical laboratories is discussed. The role of direct microscopic examination in the early and more rapid diagnosis of deep mycoses is underlined.

Adult↗
PubMed1990

Disseminated histoplasmosis capsulatum. A report of two autopsy cases.

The autopsy findings of two cases of disseminated histoplasmosis capsulatum are reported here. The pathologic changes involved multiple organs, such as lungs, liver, spleen, kidneys, thymus, and deep and superficial lymph nodes. The main pathologic features were caseous necrosis and macrophage infiltration, which engulfed numerous histoplasma in yeast form. In the first case, the colon and skin were also attacked by histoplasma capsuli, as was the head of pancreas in the second case. Acute regression of the thymus was found in both cases.

Child, Preschool↗