Disseminated Histoplasmosis: Results of Long-Term Follow-up

Sarosi, George A.; Voth, Douglas W.; Dahl, Bernhoff A.; Doto, Irene L.; Tosh, Fred E.

doi:10.7326/0003-4819-75-4-511

Cited by 136 publications

(20 citation statements)

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“…Histoplasma rarely at University of Waterloo on April 3, 2015 http://cid.oxfordjournals.org/ Downloaded from infects the spinal cord. The mortality without treatment is 80% but can be reduced to !25% with antifungal therapy [6,[11][12][13][14][15][16][17][18][19][20][21][22] (table 4). Treatment is indicated for all patients with progressive disseminated histoplasmosis.…”

Section: Disseminated Histoplasmosismentioning

confidence: 99%

Practice Guidelines for the Management of Patients with Histoplasmosis

Wheat

Sarosi

McKinsey

et al. 2000

Clinical Infectious Diseases

345

196

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Section: Disseminated Histoplasmosismentioning

confidence: 99%

Practice Guidelines for the Management of Patients with Histoplasmosis

Wheat

Sarosi

McKinsey

et al. 2000

Clinical Infectious Diseases

345

196

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“…CT scan shows markedly enlarged adrenals, often with necrosis in the central area (160). Adrenal insufficiency was a frequent cause of death in earlier years (110). Mucous membrane lesions are also more frequently seen in disseminated histoplasmosis than in other endemic mycoses, with the exception of paracoccidioidomycosis (50,104,119).…”

Section: Disseminated Histoplasmosismentioning

confidence: 99%

“…This includes Addison's disease, which occurs when there is extensive destruction of both adrenal glands by the infection. The patient exhibits fever, malaise, orthostatic hypotension, nausea, and vomiting (110,119). Hyperkalemia, hyponatremia, and eosinophilia are usually present.…”

Section: Disseminated Histoplasmosismentioning

confidence: 99%

“…Treatment options have increased considerably since then (Table 4). A series of clinical trials that established the effectiveness of amphotericin B was performed in the 1950s and 1960s by the National Communicable Disease Center (forerunner of the Centers for Disease Control and Prevention) Cooperative Mycoses Study Group and the Veterans Administration-Armed Forces Cooperative Study on Histoplasmosis (39,96,110,123). In the same time period, investigators at the National Institutes of Health and the Missouri State Sanitorium reported on their experiences with treatment of disseminated histoplasmosis with amphotericin B (104,119).…”

Section: Treatment Treatment Optionsmentioning

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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“…The patient exhibits fever, malaise, fatigue, orthostatic hypotension, nausea, and vomiting. 24,25 CT scan shows markedly enlarged adrenals, often with necrosis in the central area. 26 In our case, the picture is consistent with the features of adrenal failure that developed gradually and investigations also revealed partial deficiency in ACTH stimulation test.…”

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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Disseminated Histoplasmosis: Results of Long-Term Follow-up

Cited by 136 publications

References 12 publications

Practice Guidelines for the Management of Patients with Histoplasmosis

Practice Guidelines for the Management of Patients with Histoplasmosis

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

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