SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
A case of disseminated histoplasmosis with cutaneous lesions due to Histoplasma capsulatum is reported. The patient was a 22 years old congolese woman (Zaïre). The diagnosis was made on born narrow a few days only before she died. The cutaneous lesions were also positive for H. capsulatum.
A case of central nervous system histoplasmosis located at the pons is reported. The authors point out difficulties for the diagnosis of the pathology during life and some aspects of the treatment and their results. The rarity of the process is emphasized.
Although Histoplasma capsulatum is not generally considered an opportunistic organism, we have seen five corticosteroid-treated patients in whom disseminated histoplasmosis (DH) developed. Persistent, unexplained fever was the predominant symptom in each. Death was directly attributable to DH in four. The interval from onset of symptoms to diagnosis ranged from 11 to 75 days; delay in diagnosis adversely affected prognosis. Culture of the bone marrow appears to be the best diagnostic study. The pathologic features of DH in immunocompromised hosts are the presence of large numbers of Histoplasma yeast forms within macrophages, absence of discrete granulomas, and a reduced or absent inflammatory response. Histoplasma capsulatum should be considered as a possible cause in any immunosuppressed patient with unexplained fever, especially if the patient has been receiving corticosteroid therapy.
Supernatant culture media obtained from adherent spleen cell preparations of mice experimentally infected with Histoplasma capsulatum yeast cells suppressed in vitro growth of human myeloid cells. This suppression was significantly greater than that obtained when splenocytes from normal mice or those inoculated with killed yeast cells were used. The use of indomethacin partially blocked this suppressive effect. A direct relationship was observed between the levels of prostaglandin E (PGE) per 10(6) adherent cells in the splenocyte preparations and the degree of in vitro myelosuppression. These findings suggest a possible mechanism for the leukopenia frequently observed in disseminated histoplasmosis.
Two patients with histoplasmosis who came from the same environment are described. Diagnosis was achieved through biopsy and culture since they had not the common clinical forms but, fundamentally, skin and mucosa lesions. In both cases difficulties in establishing the differential diagnosis with neoplasms, lymphomas, leukosis and tuberculosis were faced. The diagnosis was precised by biopsy and culture. Positive results were obtained from amphotericin B therapy at the doses administered.
Report on a case of histoplasmosis with laryngeal symptoms only, affecting no other organ, especially the lungs, which is rare. Diagnosis was made by histological identification of the intracellular mycosis without culture. Immunological reactions were positive against American forms whereas the patient had lived in Africa. Healing occurred after intravenous amphotericin.
The pulmonary scintigraphic findings from four patients with fibrosing mediastinitis due to histoplasmosis are reported. The ventilation/perfusion (V/Q) mismatch mimicked pulmonary emboli. However, in these cases the chest radiographs and/or gallium-67 scintigraphy were abnormal, suggesting mediastinal or hilar disease. Awareness of the nonembolic conditions that can result in V/Q mismatches is important in the interpretation of lung scans.
Two cases of African histoplasmosis culturally proven to be caused by Histoplasma duboisii are reported from Eastern Nigeria. One case had cutaneous papules and subcutaneous nodules all over his body while the other patient had cutaneous papules, an abscess over the right scapula, enlarged cervical, axillary and inguinal lymph nodes, and possible lung involvement. None of the 35 soil samples collected from the environment of the two patients were found positive for H. duboisii. In the first case, most of the lesions cleared with Septrin given orally. The 2nd case responded very well to treatment with intravenous Amphotericin B except for persistance of swellings in the inguinal lymph nodes. The effect of intralesional injection of Amphotericin B on this residual lymph node infection is now being assessed.
Primitive pulmonary histoplasmosis is a rural endemy in Republic of Mexico. Many cases remain unknown because the lack of specialized facilities. Contamination is always due to guano bats. In 1979, the author observed 8 epidemic foci involving 79 patients, with a high mortality.
A fifty-one year old man on chronic steroid therapy presented with a cellulitis-erysipelas-like eruption which proved to be histoplasmosis without demonstrable systemic involvement. This presentation deviates from the five previously reported cases, two nodular and three noduloulcerative, all of which presented as a self-limited, minimally tender lesion.
The clinical features of 24 cases of disseminated canine histoplasmosis are presented. The enteric form predominated and the age at presentation was from five months to ten years. The principal clinical findings were chronic diarrhea, weight loss, pyrexia and anemia.A premortem diagnosis was reached in 20 cases, by demonstrating Histoplasma capsulatum organisms in peripheral blood smears, rectal scrapings or surgical biopsies. Five of seven dogs treated with amphotericin B were released in asymptomatic condition. Four of these cases relapsed six to 15 months following therapy. The overall mortality rate was 80%.
In two cases of naturally occurring disseminated histoplasmosis, multifocal inflammatory lesions were seen in the posterior segment of the eyes. Histologic examination of both animals revealed lesions of active choroiditis (cat) and retinitis (dog) in association with numerous Histoplasma capsulatum.
This is a case report of two patients who suffered from African histoplasmosis. Clinical, histological, and mycological characteristics, and the treatment are described.
OBJECTIVE: To determine whether laser photocoagulation of peripapillary choroidal neovascularization (CNV) or large neovascular lesions that are located nasal to the fovea is beneficial with respect to preservation of remaining vision--consistent with the overall study findings. PATIENTS AND INTERVENTIONS: A total of 113 eyes (112 patients) having either peripapillary CNV or CNV that was located nasal to the fovea and larger than 750 microns in longest diameter associated with either ocular histoplasmosis or idiopathic causes were identified from the eyes that were randomly assigned to either laser photocoagulation or observation only in clinical trials conducted by the Macular Photocoagulation Study Group. MAIN OUTCOME MEASURES: Visual acuity and change in visual acuity from baseline examination were compared for laser-treated and untreated eyes. RESULTS: At the 3-year examination, 11% (6/54) of the treated eyes vs 41% (21/51) of the untreated eyes had lost six or more lines of visual acuity (P < .001). Among eyes with peripapillary lesions, 14% (3/22) of the treated eyes vs 26% (6/23) of the untreated eyes had lost six or more lines of visual acuity at the 3-year examination (P = .29). Among eyes with nasal lesions, 9% (3/32) of the treated eyes vs 54% (15/28) of the untreated eyes had lost six or more lines of visual acuity at the 3-year examination (P < .001). CONCLUSION: Results from the subset of patients who had extrafoveal or juxtafoveal peripapillary CNV or CNV that was located nasal to the fovea were consistent with the beneficial results of treatment observed in the entire group of eyes that were studied by the Macular Photocoagulation Study Group.
No matter how typical a cutaneous eruption may be in a patient with the acquired immunodeficiency syndrome, early histologic evaluation is necessary if a delay in diagnosis and treatment is to be avoided. We report the case of a 33-year-old man with acquired immunodeficiency syndrome who was clinically misdiagnosed as having a drug-induced eruption. Three weeks later he died with disseminated histoplasmosis.
Subretinal neovascular membranes located under the fovea typically lead to significant visual loss. Laser treatment has been limited due to the anatomic location of the neovascular process, but surgical removal has been reported with promising results. We surgically removed a long-standing, presumed ocular histoplasmosis syndrome (POHS) subfoveal neovascular membrane that had been present for 10 months in a patient's only functional eye, with unexpected good results. This case suggests that the good visual outcomes achieved by surgically excising smaller subfoveal neovascular membranes early in their natural history also can be achieved in selected patients with more chronic and severe subfoveal neovascular processes.
A case of pulmonary histoplasmosis in Beijing was reported Patient's CT scan showed naly patchy consolidation partly with small cavitations and hilar silhouette enlarged in both lungs. On pathologic examination, Histoplasma Capsutatums were found in the lung tissures by percutaneous lung biopsy. Skin rash had developed in the course. After treated by fluconaxole, most of the lung lesions and skin rash disappeared.
The authors report a case of disseminated pulmonary histoplasmosis in an HIV positive patient who had travelled in countries where the disease was endemic. The principle clinical characteristics of the disease are reviewed including the radiology and the methods of treatment particularly in the forms occurring in this context. Finally the authors underline the difficulty in the differential diagnosis with tuberculosis.