Importance of the association of molecular and immunological diagnosis in immunocompetent patient with Histoplasma capsulatum and Cryptoccocus neoformans infection: a case report

Abstract

This case reports an immunocompetent 29-year-old woman with suspected pneumonia, suggestive of fungal infection. Immunoblotting analysis reactivity against Histoplasma capsulatum and Paracoccidioides brasiliensis were observed. Nested-PCR in blood employing species-specific primers was positive for H. capsulatum and Cryptococcus neoformans. The evaluation of paucisymptomatic patients with positive results for H. capsulatum and C. neoformans could be relevant for the prevention as well as the possible evaluation of the reactivated quiescent foci. In conclusion, the associated methodology may have contributed to the monitoring endogenous reactivation of these diseases.

Enhanced virulence of Histoplasma capsulatum through transfer and surface incorporation of glycans from Cryptococcus neoformans during co-infection

“…A PubMed search for the words Hc , Cn and co-infection renders many hits 9 10 11 12 13 14 15 16 17 18 19 20 21 , including multi-center reports of several patients 9 15 20 , with the first co-infection observation reported by Mider et al in 1947 16 . The diagnoses of co-infection was made by either histological examination and/or cultures of various tissues and body fluids.…”

“…acquisition occurring concomitantly or separately). Nevertheless, a review of the literature finds a significant number of cases of Cn-Hc co-infections 9 10 11 12 13 14 15 16 17 18 19 20 21 , which establishes that co-infections can and do occur, and can progress to disease with both fungi. Identification of co-infected individuals is complicated by the fact that clinical manifestations of both mycoses and the antifungal therapy administered for them are similar (typically a polyene followed by an azole).…”