Disseminated histoplasmosis in infants

Odio, Carla; Navarrete, Marta; Carrillo, Juan; Mora, Luis Miguel Ortega; Carranza, Alfonso

doi:10.1097/00006454-199912000-00007

Cited by 67 publications

(42 citation statements)

References 21 publications

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“…The time course of the infection in these patients is measured in months, and the disease is uniformly fatal if not treated. This is in contrast to the rapidly fatal acute form of dissemination that occurs in infants and immunosuppressed patients (57,92).…”

Section: Disseminated Histoplasmosismentioning

confidence: 81%

“…This includes patients with AIDS, transplant recipients, those with hematologic malignancies, and those on corticosteroids (37,57,64,139,146). Infants, presumably because of the immaturity of their cell-mediated immune system, are a special group that develops severe life-threatening infection when exposed to H. capsulatum (35,50,92). A person who develops an immunosuppressive condition years after leaving the area of endemicity may reactivate a focus of infection and, through that mechanism, develop severe disseminated histoplasmosis (64,80).…”

Section: Disseminated Histoplasmosismentioning

confidence: 99%

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Histoplasmosis: a Clinical and Laboratory Update

2007

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SUMMARY Infection with Histoplasma capsulatum occurs commonly in areas in the Midwestern United States and Central America, but symptomatic disease requiring medical care is manifest in very few patients. The extent of disease depends on the number of conidia inhaled and the function of the host's cellular immune system. Pulmonary infection is the primary manifestation of histoplasmosis, varying from mild pneumonitis to severe acute respiratory distress syndrome. In those with emphysema, a chronic progressive form of histoplasmosis can ensue. Dissemination of H. capsulatum within macrophages is common and becomes symptomatic primarily in patients with defects in cellular immunity. The spectrum of disseminated infection includes acute, severe, life-threatening sepsis and chronic, slowly progressive infection. Diagnostic accuracy has improved greatly with the use of an assay for Histoplasma antigen in the urine; serology remains useful for certain forms of histoplasmosis, and culture is the ultimate confirming diagnostic test. Classically, histoplasmosis has been treated with long courses of amphotericin B. Today, amphotericin B is rarely used except for severe infection and then only for a few weeks, followed by azole therapy. Itraconazole is the azole of choice following initial amphotericin B treatment and for primary treatment of mild to moderate histoplasmosis.

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Section: Disseminated Histoplasmosismentioning

confidence: 81%

Section: Disseminated Histoplasmosismentioning

confidence: 99%

Histoplasmosis: a Clinical and Laboratory Update

2007

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“…16,17,18 The major risk factors that portend an increased risk for disseminated infection with H capsulatum are exposure to the organism as an infant before cell-mediated immunity is adequate to handle intracellular pathogens corticosteroids and other immunosuppressive agents given for various conditions, AIDS with CD4 cells less than 150/ mL hematologic malignancies, and solid organ transplantation. 5,8,15,[19][20][21][22][23] With increasing use of tumor necrosis factor (TNF) antagonists in many rheumatological disorders, this form of therapy has emerged as a major risk factor for histoplasmosis. 9,10,11 Interestingly in our patient there was no specific travel to an endemic area known to have histoplasmosis in abundance nor he took any immunosuppresive drugs.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Histoplasmosis in an Elderly Man Presented with Fever, Weight loss, Abdominal Pain and Haemoptysis - A Case Report with Literature Review

et al. 2011

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An elderly patient presented with prolonged fever, gross weight loss, recurrent haemoptysis and abdominal pain. He had a background history of adrenal tuberculosis with completion of treatment without any obvious improvement. Clinically he was diagnosed as a case of adrenocotical insufficiency. Evaluation including histopathology revealed the diagnosis as disseminated histoplasmosis involving adrenal gland and lungs. The disease is a rarity without any underneath immunosuppression and hence high index of suspicion with appropriate steps for investigation is the key to achieve a diagnosis of disseminated histoplasmosis in Bangladesh. Keyword: . DOI: 10.3329/jom.v12i1.6936J Medicine 2011; 12 : 81-85

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“…These patients develop transient hyperglobulinemia and T cell deficiency that improve with specific treatment [11].…”

Section: Discussionmentioning

confidence: 99%

“…Central Nervous System (CNS) involvement is recognized in 5%-10% of cases of progressive disseminated histoplamosis. [10], and is common in disseminated histoplasmosis of childhood [11]. Clinical syndromes include subacute or chronic meningitis, focal brain or spinal cord lesions, stroke syndromes and encephalitis [10,12].…”

mentioning

confidence: 99%

Chronic meningitis by histoplasmosis: report of a child with acute myeloid leukemia

Pereira¹,

Padua²,

Park³

et al. 2008

Braz J Infect Dis

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Meningitis is a common evolution in progressive disseminated histoplasmosis in children, and is asymptomatic in many cases. In leukemia, the impaired of the T cells function can predispose to the disseminated form. The attributed mortality rate in this case is 20%-40% and the relapse rate is as high as 50%; therefore, prolonged treatment may be emphasized. We have described a child with acute myeloid leukemia (AML), that developed skin lesions and asymptomatic chronic meningitis, with a good evolution after prolonged treatment with amphotericin B deoxycholate followed by fluconazole.

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Disseminated histoplasmosis in infants

Cited by 67 publications

References 21 publications

Histoplasmosis: a Clinical and Laboratory Update

Histoplasmosis: a Clinical and Laboratory Update

Disseminated Histoplasmosis in an Elderly Man Presented with Fever, Weight loss, Abdominal Pain and Haemoptysis - A Case Report with Literature Review

Chronic meningitis by histoplasmosis: report of a child with acute myeloid leukemia

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