Clinical and evolutionary characteristics of four patients with pulmonary histoplasmosis reported in the Paraíba Paulista Valley region

Abstract

The type of pulmonary histoplasmosis presents limited lesions to the lungs, with symptoms that are clinically and radiological similar to chronic pulmonary tuberculosis. This paper describes the clinical features of four cases of pulmonary histoplasmosis. Aspects of diagnostic and clinical, epidemiological, laboratorial and imaging exams are discussed, in addition to the clinical status of the individuals five years after disease onset. The treatment of choice was oral medication, following which all the patients improved. It is important to understand the clinical status and the difficulties concerning the differential diagnosis of histoplasmosis, to assist the proper indication of cases, thus reducing potential confusion with other diseases.

Development of a Loop-Mediated Isothermal Amplification Method for Detection of Histoplasma capsulatum DNA in Clinical Samples

“…Timely detection of PDH is problematic in resource-challenged countries, since few rapid assays exist for this disease (1) and its symptoms are vague and often confused with those of mycobacterial or leishmanial infections (2,3). Many laboratories in resource-limited areas in which the disease is endemic rely on sterile-site cultures for diagnosis of PDH; however, H. capsulatum grows slowly and may take several weeks for identification in cultures.…”

Histoplasmosis pulmonar crónica en un adulto inmunocompetente

“…El 90% de las infecciones agudas es subclínica, los demás pacientes tienen un cuadro clínico similar al de la influenza, algunos de estos con neumonitis en parches que se resuelve espontáneamente la mayoría de las veces, quedando con focos de infección latentes que se pueden reactivar si la inmunidad del huésped decae, dando lugar a una infección diseminada. Las formas crónicas usualmente se describen en hombres mayores de 50 años con enfermedad pulmonar previa (principalmente enfisema) y fumadores (7,8).…”

“…Las manifestaciones clínicas incluyen tos con expectoración purulenta, disnea, anorexia, pérdida de peso, astenia, adinamia y, ocasionalmente, fiebre (7). Los principales hallazgos radiológicos son enfisema con bulas de distribución heterogénea, retracciones hiliares y engrosamiento pleural, así como el desarrollo de nódulos.…”

A gingival manifestation of histoplasmosis leading diagnosis

“…Fever and persistent cough associated with weight loss and chest pain are seen for chronic cases, which can be easily misinterpreted as tuberculosis, as occurred with our patient. [1314] This hypothesis could not be completely discarded by microscopy and culture because cases of sputum smear negative tuberculosis have increased in the medical practice. [15] The suspicious of pulmonary histoplasmosis also could not be confirmed by microscopy and culture.…”