Acute Kidney Injury, Immune Thrombocytopenic Purpura, and the Infection That Binds Them Together: Disseminated Histoplasmosis

Sethi, Pooja; Treece, Jennifer; Onweni, Chidinma; Pai, Vandana; Arikapudi, Sowminya; Kallur, Lakshmi; Kohli, Varun; Moorman, Jonathan P.

doi:10.1177/2324709617746193

Cited by 2 publications

(4 citation statements)

References 23 publications

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“…In Mexico and Central America, HP is the most common mycosis, estimated to have an incidence of 0.1 to 0.29 cases/100,000 inhabitants [9]. The Human Immunodeficiency Virus (HIV) and immunosuppressors are associated with an increase in cases of HP [5,10]. In the present case, one possible factor that contributed to the development of DH was the over-immunosuppression (supraoptimal TAC levels).…”

Section: Discussionmentioning

confidence: 65%

Refractory Thrombocytopenia Associated to Disseminated Histoplasmosis in a Living-Related Renal Transplant Recipient: A Case Report and Review of the Literature

MD¹,

G-G²,

AOA³

et al. 2021

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Opportunistic infections are frequent complications after renal transplantation because of the use of immunosuppressants. Disseminated Histoplasmosis (DH) is one such opportunistic infection, and its clinical presentation varies, which makes its diagnosis a challenge. There is no information regarding DH as a cause of refractory thrombocytopenia in renal transplant recipient (RTR); therefore, we consider this an atypical case, and, because of its clinical characteristics, we have classified it as an Immune Thrombocytopenic Purpura (ITP) induced by histoplasmosis. This is the first case reported in our milieu, and it opens up the possibility for use of intravenous immunoglobulin as a strategic therapy for thrombocytopenia induced by HP in immunosuppressed RTRs.

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Section: Discussionmentioning

confidence: 65%

Refractory Thrombocytopenia Associated to Disseminated Histoplasmosis in a Living-Related Renal Transplant Recipient: A Case Report and Review of the Literature

MD¹,

G-G²,

AOA³

et al. 2021

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“…Most immunocompetent hosts have either no symptoms or a mild form of this illness. 23 The disseminated form of the histoplasmosis is associated with extremes of age and impairment of host's immune defenses, mainly cellular immunity, such as immunosuppressive medications, primary immunodeficiency, and HIV infection, which is considered the greatest risk factor for PDH, 24 sometimes developing septic shock and organic dysfunction. 11 The primary focus of the infection is the lung.…”

Section: Clinical and Laboratory Featuresmentioning

confidence: 99%

“…9,25,28,29 In -HIV-patients, CD4 + counts are typically lower than 200 cells/ microL, and patients with higher counts usually develop mild or asymptomatic disease. 23 The chest radiographic findings are diverse and nonspecific including normal pattern, or diffuse reticulonodular or interstitial infiltrate. Similar nodular opacities are reported in HIV patients infected with Mycobacterium tuberculosis or Cryptococcus spp.…”

Section: Clinical and Laboratory Featuresmentioning

confidence: 99%

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Progressive disseminated histoplasmosis in HIV-positive patients

et al. 2022

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Background: Histoplasmosis is the most common endemic mycosis among people living with advanced HIV infection. Purpose: Describe general aspects and challenges of this disease and its association with HIV. Research Design: Review of literature. Study Sample: Articles found using different combinations of terms including “disseminated histoplasmosis” and AIDS/HIV or immunosuppression in PubMed, Scopus, WHO Global health library, and Scielo database. Analysis: We look for information on epidemiology, pathogenesis, diagnosis, and treatment of histoplasmosis in AIDS patients. Results: Histoplasmosis is caused by Histoplasma capsulatum, a dimorphic fungus encountered throughout the world, mainly in soil enriched with bat and bird excreta. Progressive disseminated histoplasmosis is the main presentation of this mycosis in people living with advanced HIV and is fatal if left untreated. Symptoms include a systemic disease characterized by fever, weight loss, night sweats, skin manifestations, hepatomegaly, splenomegaly, and septic shock. Diagnostic tests include culture, visualization of H. capsulatum by direct and histopathological examination, serology, antigen, molecular, and skin testing. Patients with disseminated disease require aggressive and prolonged treatment to eradicate the pathogen and include amphotericin B and itraconazole. In many low income countries of endemic regions, histoplasmosis in HIV-positive patients is often undiagnosed or misdiagnosed as another opportunistic infection, due to the similarity in clinical manifestations and to the paucity of better diagnostic tests. Conclusion: Histoplasmosis remains a neglected disease. Few studies about the disease and expensive treatments make it difficult to reduce the morbidity and mortality of this condition. Public health services and physicians must be aware of histoplasmosis' burden among the HIV-positive population.

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Acute Kidney Injury, Immune Thrombocytopenic Purpura, and the Infection That Binds Them Together: Disseminated Histoplasmosis

Cited by 2 publications

References 23 publications

Refractory Thrombocytopenia Associated to Disseminated Histoplasmosis in a Living-Related Renal Transplant Recipient: A Case Report and Review of the Literature

Refractory Thrombocytopenia Associated to Disseminated Histoplasmosis in a Living-Related Renal Transplant Recipient: A Case Report and Review of the Literature

Progressive disseminated histoplasmosis in HIV-positive patients

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