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Histoplasmosis

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1. Histoplasmosis

Histoplasmosis Histoplasmosis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Histoplasmosis Last reviewed: February 2019 Last updated: March 2018 Summary Infection is usually asymptomatic or minimally symptomatic; however, infection with a large number of organisms or in people with immunodeficiency can result in severe, symptomatic pulmonary infection, which requires treatment. Risk factors for more severe (...) respiratory disease include inhalation of a large inoculum, impaired cellular immunity (e.g., AIDS/HIV infection, chronic immunosuppressive therapy), age <2 years, and chronic lung disease. Endemic in temperate regions of the world including the Ohio, Mississippi, and Missouri River valleys in the US, southern Mexico, the Caribbean, and Central and South America. African histoplasmosis is a different clinical entity and is not covered in this topic. The fungus proliferates well in soil contaminated

2018 BMJ Best Practice

3. Prior subclinical histoplasmosis revealed in Nigeria using histoplasmin skin testing. Full Text available with Trip Pro

Prior subclinical histoplasmosis revealed in Nigeria using histoplasmin skin testing. Disseminated histoplasmosis is an AIDS-defining illness. Histoplasmosis is commonly misdiagnosed as tuberculosis. Nigeria has the second highest number of people living with HIV/AIDS in Africa. The present study was carried out to investigate the prevalence of skin sensitivity amongst Nigerians to histoplasmin.A cross-sectional study was conducted in six centres across five geopolitical zones of Nigeria.We (...) %)) and no positives were recorded in Lagos (p<0.001). HIV status was not statistically significant (p = 0.70).Histoplasmosis diagnostics should be included in the Nigerian HIV guidelines. Epidemiological vigilance of progressive disseminated histoplasmosis should be considered by local health authorities.

2018 PLoS ONE

4. PRN Ranibizumab in the Treatment of Choroidal Neovascularization Secondary to Ocular Histoplasmosis. (Abstract)

PRN Ranibizumab in the Treatment of Choroidal Neovascularization Secondary to Ocular Histoplasmosis. Ranibizumab (Lucentis; Genentech, South San Francisco, CA) is used off-label for the treatment of choroidal neovascularization secondary to ocular histoplasmosis syndrome (OHS). This study prospectively evaluates the safety and efficacy of two treatment paradigms utilizing ranibizumab 0.5 mg: one or three initial injections followed by monthly visits with PRN treatment through Month 12

2019 Ophthalmic surgery, lasers & imaging retina Controlled trial quality: uncertain

5. Disseminated histoplasmosis from a calcified lung nodule after long-term corticosteroid therapy in an elderly Japanese patient: A case report. Full Text available with Trip Pro

Disseminated histoplasmosis from a calcified lung nodule after long-term corticosteroid therapy in an elderly Japanese patient: A case report. Histoplasmosis occurs most commonly in Northern and Central America and Southeast Asia. Increased international travel in Japan has led to a few annual reports of imported histoplasmosis. Healed sites of histoplasmosis lung infection may remain as nodules and are often accompanied by calcification. Previous studies in endemic areas supported (...) the hypothesis that new infection/reinfection, rather than reactivation, is the main etiology of symptomatic histoplasmosis. No previous reports have presented clinical evidence of reactivation.An 83-year-old Japanese man was hospitalized with general fatigue and high fever. He had been treated with prednisolone at 13 mg/d for 7 years because of an eczematous skin disease. He had a history of travel to Los Angeles, Egypt, and Malaysia 10 to 15 years prior to admission. Five years earlier, computed tomography

2019 Medicine

6. A case report of disseminated histoplasmosis and concurrent cryptococcal meningitis in a patient treated with ruxolitinib. Full Text available with Trip Pro

A case report of disseminated histoplasmosis and concurrent cryptococcal meningitis in a patient treated with ruxolitinib. Ruxolitinib is a highly potent janus kinase inhibitor that places its users at risk for various bacterial infections and viral reactivation. However new reports are also emerging that suggest greater immunosuppression and risk for fungal disease.We report the case of a 51 year-old veteran from Guam, treated with ruxolitinib for polycythemia vera, who developed disseminated (...) histoplasmosis and concurrent cryptococcal meningitis.This case draws attention to the degree of immunosuppression that may be seen with this drug and the need for heightened vigilance for opportunistic infections in those treated with inhibitors of janus kinase/signal transducers and activators of transcription (JAK/STAT) such as ruxolitinib.

2019 BMC Infectious Diseases

7. Head and neck involvement with histoplasmosis; the great masquerader. (Abstract)

Head and neck involvement with histoplasmosis; the great masquerader. Head and neck involvement with histoplasmosis usually occurs as a part of the disseminated illness. There are no pathognomic features of the upper aerodigestive tract involvement and the lesion may mimic a host of other conditions. The current report presents our experience with head and neck histoplasmosis in a non-endemic tertiary care center.We present a case of disseminated histoplasmosis with oral symptoms and lesions (...) as the chief complaints. A 10 years' retrospective institutional database search was undertaken to identify the patients with histoplasmosis affecting head and neck region treated at our institution. The demographic and treatment details of the patients were reviewed.In addition to the index patient, four more patients (two with gingivobuccal and one each with nasal and laryngeal histoplasmosis) were found. Out of the five patients, only one patient was found to have underlying immunosuppression. All

2019 American Journal of Otolaryngology

8. Disseminated cutaneous-only histoplasmosis in a patient with AIDS. (Abstract)

Disseminated cutaneous-only histoplasmosis in a patient with AIDS. Histoplasmosis is an opportunistic fungal infection that occurs predominantly in immunocompromised patients. Cutaneous lesions in histoplasmosis are rare and typically occur in the absence of extra-cutaneous manifestations. We present a rare case of disseminated cutaneous-only histoplasmosis in a patient with recently diagnosed AIDS.© 2019 The Australasian College of Dermatologists.

2019 Australasian Journal of Dermatology

9. Histoplasmosis in an elderly polish tourist - a case report. Full Text available with Trip Pro

Histoplasmosis in an elderly polish tourist - a case report. Histoplasmosis is a mycosis caused by soil-based fungus Histoplasma capsulatum endemic in the USA, Latin America, Africa and South-East Asia. The disease is usually self-resolving, but exposure to a large inoculum or accompanying immune deficiencies may result in severe illness. Symptoms are unspecific with fever, cough and malaise as the most common. Thus, this is a case of disease which is difficult to diagnose and very rare (...) presentation and history of travel to Mexico before onset of disease, pulmonary histoplasmosis was diagnosed. After introduction of antifungal treatment rapid improvement was achieved in terms of both clinical picture and respiratory function.Since the risk of Histoplasma exposure in Europe is minimal, patients, who present with dyspnea, fever and malaise are not primarily considered for diagnosis of histoplasmosis. However, taking into account increasing popularity of travelling, also by elderly

2019 BMC pulmonary medicine

10. Progressive disseminated histoplasmosis with concomitant disseminated nontuberculous mycobacterial infection in a patient with AIDS from a nonendemic region (California). Full Text available with Trip Pro

Progressive disseminated histoplasmosis with concomitant disseminated nontuberculous mycobacterial infection in a patient with AIDS from a nonendemic region (California). Opportunistic infections, while well studied in the AIDS population, continue to have variable and surprising presentations. Here, we present a case of disseminated histoplasmosis with disseminated nontuberculous mycobacterial infection in a 50 year old man with long standing AIDS living in a non-endemic area.Patient presented (...) in non endemic areas should therefore be careful to not overlook specific organisms based on a lack of a recent travel history. Physicians in nonendemic areas should become more familiar with the clinical findings and diagnostic approach of infectious such as Histoplasmosis, to ensure earlier recognition and treatment in immunocompromised individuals.

2019 BMC pulmonary medicine

11. Case Report: Hemophagocytic Lymphohistiocytosis Caused by Disseminated Histoplasmosis in a Venezuelan Patient with HIV and Epstein-Barr Virus Reactivation Who Traveled to Japan. Full Text available with Trip Pro

Case Report: Hemophagocytic Lymphohistiocytosis Caused by Disseminated Histoplasmosis in a Venezuelan Patient with HIV and Epstein-Barr Virus Reactivation Who Traveled to Japan. We describe a Venezuelan visitor to Japan who was diagnosed with hemophagocytic lymphohistiocytosis (HLH). The patient was also diagnosed with human immunodeficiency virus (HIV) and Epstein-Barr virus infection by the Western blot and polymerase chain reaction (PCR) tests, respectively. The cause of HLH was considered (...) to be these two infections at first; however, the patient did not recover with antiretroviral/anti-herpes virus therapy. Thereafter, diagnosis of disseminated histoplasmosis was confirmed with an antigen detection test, culture, and PCR test of blood, urine, and bone marrow, and the patient improved gradually after the initiation of liposomal amphotericin B. This case highlights the importance of ruling out endemic mycosis as a cause of HLH even if other probable causes exist in patients from endemic areas.

2019 American Journal of Tropical Medicine & Hygiene

12. Oropharyngeal histoplasmosis: a report of 10 cases. (Abstract)

Oropharyngeal histoplasmosis: a report of 10 cases. A wide differential diagnosis must be entertained in patients with unusual oral and pharyngeal ulcerations. A mucosal biopsy is essential. We retrospectively reviewed 10 cases from the Infectious Diseases Division at Mayo Clinic Rochester (MN, USA), in which the diagnosis proved to be Histoplasma capsulatum infection. Between 1995 and 2016, 10 patients were diagnosed with oropharyngeal histoplasmosis. Common presenting symptoms included weight (...) loss, weakness and oropharyngeal pain with ulcerations. Despite specialty evaluation at other facilities, diagnostic delay occurred in six patients due to lack of biopsy or fungal staining. Yeast forms consistent with H. capsulatum were identified in the biopsy specimens of all our patients. Treatment included intravenous amphotericin B and prolonged courses of azoles. Oral histoplasmosis occurred in both immunocompetent and immunosuppressed patients, and was a manifestation of disseminated

2019 Clinical & Experimental Dermatology

13. Histoplasmosis-related healthcare use, diagnosis, and treatment in a commercially insured population, United States. Full Text available with Trip Pro

Histoplasmosis-related healthcare use, diagnosis, and treatment in a commercially insured population, United States. Infections with Histoplasma can range from asymptomatic to life-threatening acute pulmonary or disseminated disease. Histoplasmosis can be challenging to diagnose and is widely under-recognized. We analyzed insurance claims data to better characterize histoplasmosis testing and treatment practices and its burden on patients.We used the IBM® MarketScan® Research Databases (...) to identify patients with histoplasmosis (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 115.00-115.99) during 2012-2014. We analyzed claims in the 3 months before to the 1 year after diagnosis and examined differences between probable (hospitalized or >1 outpatient visit) and suspect (1 outpatient visit) patients.Among 1,935 patients (943 probable, 922 suspect), 54% had codes for symptoms or findings consistent with histoplasmosis and 35% had ≥2

2019 Clinical Infectious Diseases

14. A challenging case of pyrexia of unknown origin: adrenal histoplasmosis mimicking tuberculosis in a patient with chronic hepatitis C. (Abstract)

A challenging case of pyrexia of unknown origin: adrenal histoplasmosis mimicking tuberculosis in a patient with chronic hepatitis C. We present an unusual case of fever of unknown origin with bilateral adrenal masses in a patient with compensated chronic liver disease (compensated) due to hepatitis C who had been treated elsewhere with four months of anti-tuberculous therapy for suspected disseminated tuberculosis (TB). At our institution, he underwent a CT-guided biopsy of the adrenal lesion

2018 Tropical Doctor

15. Cryptococcal fungemia and probable histoplasmosis in a patient infected with HIV. Case report. Full Text available with Trip Pro

Cryptococcal fungemia and probable histoplasmosis in a patient infected with HIV. Case report. Those infected by human immunodeficiency virus (HIV) have a higher risk of opportunistic infections. The risk is related to the level of immunosuppression. We report a case of a young male with the unusual scenario of three opportunistic infections occurring simultaneously: Cryptococcosis, Histoplasmosis and Cryptosporidiosis. Histoplasmosis and cryptococcosis are major causes of morbimortality (...) in immunocompromised patients due to HIV infection.We report the case of a patient with HIV infection with a CD4 T lymphocyte cell (CD4) count of 2 cells/mm3, who presented with 6 months of diarrhea, non-productive dry cough, nocturnal diaphoresis, fever, weight loss, and a maculopapular rash. He had a concurrent infection with three opportunistic microorganisms: fungemia by cryptococcosis, disseminated histoplasmosis confirmed by detection of the antigen in urine and chronic diarrhea by cryptosporidiosis

2018 BMC Infectious Diseases

16. Histoplasmosis following Systemic Immunomodulatory Therapy for Ocular Inflammation. (Abstract)

Histoplasmosis following Systemic Immunomodulatory Therapy for Ocular Inflammation. Histoplasmosis is a known complication of systemic immunosuppressive therapy, particularly among patients who are receiving tumor necrosis factor α inhibitors. There are limited data on the development of disseminated or pulmonary histoplasmosis among patients who are receiving systemic immunosuppressive medication for noninfectious ocular inflammation.Retrospective case series.We reviewed all patients (...) with uveitis or scleritis who subsequently developed pulmonary or disseminated histoplasmosis at the Mayo Clinic in Rochester, Minnesota between September 1, 1994 and July 1, 2017, with a 3:1 age- and sex-matched control cohort who did not develop histoplasmosis. This was a single institutional study examining patients that developed histoplasmosis after the initiation of systemic immunomodulatory therapy (IMT). Patients had to develop either disseminated or pulmonary histoplasmosis while receiving

2018 American Journal of Ophthalmology

17. Burden of HIV-associated histoplasmosis compared with tuberculosis in Latin America: a modelling study. Full Text available with Trip Pro

Burden of HIV-associated histoplasmosis compared with tuberculosis in Latin America: a modelling study. Fungal infections remain a major contributor to the opportunistic infections that affect people living with HIV. Among them, histoplasmosis is considered neglected, often being misdiagnosed as tuberculosis, and is responsible for numerous deaths in Latin America. The objective of this study was to estimate the burden of HIV-associated histoplasmosis compared with tuberculosis in Latin (...) American countries.For this modelling study, we estimated prevalence of previous exposure to Histoplasma capsulatum, HIV-associated histoplasmosis annual incidence, and number of deaths in 2012 in Latin American countries based on historical histoplasmin skin test studies in the general population, with an antigen dilution level of more than 1/10. Studies were identified in a literature search. Data on HIV-associated tuberculosis were extracted from the WHO notifications and outcomes tables and data

2018 Lancet infectious diseases

18. A Case of Isolated Gastrointestinal Histoplasmosis Full Text available with Trip Pro

A Case of Isolated Gastrointestinal Histoplasmosis Histoplasmosis is a self-limited and asymptomatic disease in immunocompetent individuals. Patients with untreated human immunodeficiency virus (HIV) or immune suppression due to medications such as corticosteroids can present with disseminated and life-threatening infections. We present a case of a 60-year-old female that presented with recurrent diarrhea that was found to have isolated gastrointestinal (GI) histoplasmosis. The rarity (...) of this case is due to the isolated colonic involvement and lack of respiratory symptoms (the portal of infection). In conclusion, clinicians should be aware of isolated histoplasmosis affecting the GI tract and careful endoscopic evaluation with adequate sampling is warranted to confirm the diagnosis.

2018 Cureus

19. Disseminated Histoplasmosis as AIDS-presentation. Case Report and Comprehensive Review of Current Literature Full Text available with Trip Pro

Disseminated Histoplasmosis as AIDS-presentation. Case Report and Comprehensive Review of Current Literature Progressive disseminated histoplasmosis (PDH) is an AIDS-defining illness with a high lethality rate if not promptly treated. The wide range of its possible clinical manifestations represents the main barrier to diagnosis in non-endemic countries. Here we present a case of PDH with haemophagocytic syndrome in a newly diagnosed HIV patient and a comprehensive review of disseminated (...) histoplasmosis focused on epidemiology, clinical features, diagnostic tools and treatment options in HIV-infected patients.

2018 Mediterranean journal of hematology and infectious diseases

20. Miliary Histoplasmosis in a Patient with Rheumatoid Arthritis Full Text available with Trip Pro

Miliary Histoplasmosis in a Patient with Rheumatoid Arthritis Miliary histoplasmosis is a rare presentation that may mimic miliary tuberculosis. We report a case of miliary histoplasmosis in a 52-year-old male who was being treated with hydroxychloroquine, methotrexate, and sulfasalazine for his rheumatoid arthritis and presented to the emergency department with shortness of breath and fevers. Computed tomography (CT) chest revealed miliary pulmonary nodules. Urine Histoplasma antigen and serum (...) Histoplasma antigen were negative; however, Coccidioides immitis complement immunofixation assay and Coccidioides IgM were positive. The patient was initiated on treatment for pulmonary coccidioidomycosis and immunosuppression was held. However, a few days later, Histoplasma capsulatum was isolated from cultures from bronchoscopy. This case highlights the difficulty in diagnosing histoplasmosis in immunocompromised patients and the importance of having a broad differential diagnosis for miliary pulmonary

2018 Case reports in medicine

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