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PubMed1985

[Value and limits of serological methods: electrosyneresis and E.L.I.S.A. for the study of the prevalence of histoplasmosis in Mali].

The authors have looked for circulating antibodies on 168 subjects for the study of the prevalence of histoplasmosis in Mali. Two serologic systems were employed: with counter-immunoelectrophoresis precipitating bands were detected in 42% of sera, while 57% were positive with Enzyme-linked immunosorbent assay. E.L.I.S.A. appear less specific because many cross-reactions were observed with other diseases.

Antibodies↗
PubMed1979

Histoplasmosis and Lennert's lymphoma.

Histoplasma capsulatum was cultured from splenic tissue obtained at diagnostic laparotomy in a patient with "Lennert's lymphoma." The patient had no clinical features suggesting histoplasmosis, and the organism was not seen on histologic specimens. It is suggested that mycologic cultures as well as histopathological examinations of surgical specimens be performed routinely in immunologically compromised individuals.

Histoplasmosis↗
PubMed1979

Systemic histoplasmosis with oesophageal obstruction due to Histoplasma granulomas. Successful treatment with rifampicin and amphotericin B.

A patient with oesophageal stenosis caused by Histoplasma granulomas is reported. He was treated with an initial combined course of intravenous amphotericin B and oral rifampicin. Complications included adrenal insufficiency, operative perforation of the oesophagus, amphotericin nephrotoxicity and tuberculosis. The histoplasmosis has not recurred for over 3 years.

Aged↗
PubMed1979

System of notation for photocoagulation in the presumed ocular histoplasmosis syndrome.

Using a notation system for evaluation of photocoagulatin of the choroidal neovascular membrane (CNVM) in presumed ocular histoplasmosis syndrome (POHS) demonstrated several advantages, which are: (1) a projector system which allowed excellent magnification of the CNVM and its distance from the foveal avascular zone (FAZ); (2) direct study of fluorescein angiographic negatives; (3) good comparison of pretreatment of posttreatment lesions in relation to FAZ; (4) a precise measurement of the surface area of each CNVM and its distance from the FAZ; and (5) an accurate and rapid way of recording and comparing data. This notation system appears valuable as a means of standardizing the examination and photographic findings from multiple institutions. Results of photocoagulatin of the CNVM are presented. Photocoagulatin of the entire CNVM appeared more effective than partial photocoagulatin of the CNVM.

Adolescent↗
PubMed1979

Histoplasmosis: clinical manifestations and surgical management.

In this retrospective study of 115 cases of histoplasmids, there were 66 male and 49 female patients ranging in age from 2 months to 79 years. The most common presenting symptoms were cough, chest pain, wheezing, weight loss, hemoptysis, and shortness of breath. Thirty-five patients (30%) were asymptomatic. Two patients had manifestations of obstruction of the superior vena cava. Radiologic findings simulated carcinoma, tuberculosis, pneumonia, and viral infections. Sixty-five patients had various operative proceudres, such as lung biopsy, wedge resection, lobectomy, pneumonectomy, resection of lymph node, and bypass of superior vena cava, for diagnosis and treatment. There were two deaths and two postoperative complications. A total of 15 patients received intravenous amphotericin B. Four patients with pneumonic infiltrates developed disseminated histoplasmosis.

Adolescent↗
PubMed1979

Histoplasmosis: clinical syndromes and management.

The fungus Histoplasma capsulatum produces a spectrum of disease forms ranging from a benign self-limited illness to progressive disseminated disease with a 50 percent mortality rate. The drug of choice, amphotericin B, must be given intravenously over a prolonged course and carries a high incidence of toxicity. Thus, optimal managment of serious forms of histoplasmosis requires considerable clinical judgment.

Acute Disease↗
PubMed1979

HLA-B7 in presumed ocular histoplasmosis maculopathy.

Sixty-four patients that fulfill the clinical criteria of the presumed ocular histoplasmosis syndrome were typed for common histocompatibility antigens. The clinical criteria included the presence of multiple peripheral punched out choroidal atropic scars, a clear vitreous, and compatible macular disciform lesions in at least one eye. Thirty-four patients were found to have HLA-B7, which is statistically significant at the p less than 0.005 level when compared to a normal population. Though this is statistically significant, other factors must be involved, as there still remain many patients with this clinical picture who do not demonstrate a common histocompatibility antigen.

Gene Frequency↗
PubMedDate not supplied

[Reactivity of a purified antigen of Paracoccidioides brasiliensis with paracoccidioidomycosis and histoplasmosis sera].

The immunoelectrophoretic reactivity of a "crude" and a "purified" antigens of Paracoccidiodes brasiliensis against the sera of confirmed cases of paracoccidioidomycosis and histoplasmosis was evaluated. The "crude" antigen revealed precipitating antibodies in both the homologous and the heterologous human sera; the number of precipitating systems being higher with the former. The "purified" antigen reacted only with the homologous sera. It is postulated that the use of such "purified" antigen may significantly reduce the non specificity of the serologic tests in the immunodiagnosis of paracoccidioidomycosis.

Antigen-Antibody Reactions↗
PubMed1977

Histoplasmosis with hypercalcemia, renal failure, and papillary necrosis. Confusion with sarcoidosis..

A 56-year-old man with a three-month history of fever, malaise, anorexia, mental confusion, and weight loss had hypercalcemia and azotemia. The chest roentgenogram was normal. Biopsy material removed 2 1/2 years previously showed noncaseating granulomas. Sarcoidosis was diagnosed, and prednisone was administered. Fever persisted, and the patient died 49 days after admission. Postmortem examination showed evidence of extensive disseminated histoplasmosis, interstitial nephritis, and papillary necrosis. This communication emphasizes the difficulty in diagnosing the etiology of disseminated, noncaseating granulomatous disease.

Body Weight↗
PubMedDate not supplied

[Disseminated Histoplasma duboisii histoplasmosis in a female inhabitant of the Ivory Coast].

The authors describe a disseminated multivisceral form of african histoplasmosis due to H. duboisii in a 45 years old black woman. Clinical examination shows characteristic lesions of skin, bones and lymph glands. Lymphography reveals lesions of deep lymph glands and laparascopy lesions of liver and spleen. First untimely stopped, treatment was started again with ketoconazole. 20 months later, the course of the disease is, as for as we can appreciate it, favourable.

Cote d'Ivoire↗
PubMed1981

[Oral ketoconazole therapy of a case of pulmonary histoplasmosis].

A 46-year-old man with recurrent pulmonary histoplasmosis was given oral treatment with ketoconazole (a new imidazole derivative related to miconazole) in a dose of 400 mg/day for 3 months, followed by 200 mg daily for 6 months. The clinical and microbiological signs disappeared and the chest X-ray cleared. The drug was well tolerated without clinical or biological side-effects. The pharmacology of ketoconazole, its indications and the results of treatment of other deep mycoses are discussed. Unlike amphotericin B, ketoconazole can be administered orally without noticeable toxicity and appears to have approximately the same fungicidal activity.

Administration, Oral↗
PubMed1982

Conditions associated with relapse of amphotericin B-treated disseminated histoplasmosis.

Progressive disseminated histoplasmosis (PDH) is a rare consequence of infection with Histoplasmia capsulatum. Usually fatal if untreated, PDH generally is cured by appropriate amphotericin B treatment. Of 31 persons with uncomplicated PDH treated with amphotericin B, we found that relapse occurred in five (16%) after an interval of up to nine years after initial therapy. Review of these five cases and 31 additional relapsing cases from the literature indicates that fungal endocarditis or endarteritis without surgical treatment, underlying lymphoreticular neoplasm, and amphotericin B dosage of less than 2 g appear to be associated with relapse of PDH.

Aged↗
PubMedDate not supplied

[A disseminated form of Histoplasma duboisii histoplasmosis in a Zaïre patient (author's transl)].

Report of a case of histoplasmosis observed in Zaïre with lymphatic, pulmonary and intestinal localizations. Histoplasma duboisii was abundant in the stools, sputum and lymphatic tissue. With no amphotericine B available, treatment first started with high dosage of miconazole which had no effect. Ketoconazole have been, then, tried, giving a clinical and biological improvement, but patient still in a very bad condition, died. Ketoconazole seems to have a rapid but not lasting effect, even with increased dosages.

Adult↗
PubMedDate not supplied

[Disseminated form of histoplasmosis caused by Histoplasma capsulatum in a Zairian child].

American histoplasmosis, characterized by its small parasitological forms, is a visceral mycosis which though rare, has already been reported in Zaïre. A new case, in a girl of 4 years is reported with bad general condition, fever and general reaction of the reticulo-endothelial system. The microscopic aspects of the yeast are given. A treatment with ketoconazole proved rapidly effective and the patient had apparently recovered when she died of measles which have in Africa and specially in fragile patients a particular severity.

Antifungal Agents↗
PubMed1983

Histoplasmosis in renal allograft recipients. Two large urban outbreaks.

During two large outbreaks, ten episodes of histoplasmosis were documented in eight renal allograft recipients. Another episode occurred before the outbreaks. Associated infections with cytomegalovirus occurred in five patients and may have further impaired cellular immunity. Prolonged fever was the predominant clinical finding; and dissemination was observed in seven of our nine patients, including three with meningitis. Special stains of tissues and the histoplasmal complement fixation test provided useful diagnostic information rapidly, while cultures were eventually positive in seven patients. Treatment with amphotericin B resulted in prompt clinical improvement in all patients, but relapse occurred in two patients one year following therapy.

Adult↗
PubMed1978

Histoplasmosis due to Histoplasma capsulatum var duboisii in a Canadian immigrant.

Histoplasmosis due to Histoplasma capsulatum var duboisii developed in a Canadian immigrant one year after his entry into Canada. He had lived in Guinea for two years prior to immigration. Lymphatic infection characterized the course of his illness. The clinical and pathologic features of this disease's distinctive skin and bone manifestations are outlined. The causal agent's mycologic features are compared with those of H capsulatum var capsulatum. Treatment with amphotericin B was successful.

Adult↗
PubMedDate not supplied

[African histoplasmosis. A case].

The case reported concerns a 12 year-old girl, native of the Cameroons, hospitalized in France for the treatment of the most severe disseminated type of African histoplasmosis (Histoplasma duboisii). In addition to a severe infectious syndrome, the child presented with 3 associated typical involvements: diffuse lymphadenopathy, skin lesions consisting of nodules of the face and trunk and suppurative osteo-articular lesions with an impressive radiological appearance: extensive bone lysis and metaphyseal fractures, without any sign of bone reconstruction, even after several months of treatment. This is rare a disease, but one that should be recognized, especially in its onset localized form, in a patient presenting with infectious osteoarthritis with a torpid evolution leading to the diagnosis of tuberculous or pyogenic infection, or even of osteosarcoma. The disseminated lesions may be difficult to distinguish from the multifocal bone lesions of sickle-cell disease osteomyelitis.

Cameroon↗
PubMed1984

Histoplasmosis presenting as erythema multiforme and polyarthritis.

Erythema multiforme and polyarthritis occurred in association with serologic evidence of primary histoplasmosis. Although such occurrences have been noted in epidemics, recognition of this triad outside of the epidemic setting has been described only once before.

Acute Disease↗