Disseminated histoplasmosis successfully treated with liposomal amphotericin B following azathioprine therapy in a patient from a nonendemic area

Poveda, Francisco; García‐Alegría, Javier; Nieves, M; Villar, Eduardo; Montiel, Natalia; Arco, Alfonso del

doi:10.1007/bf01709461

Cited by 12 publications

(3 citation statements)

References 9 publications

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“…One of the two Spanish cases involved a kidney transplant recipient, and although donor-derived infection cannot be definitely excluded, both the donor and the recipient were born in Spain and had no history of travel to endemic areas [70]; the other involved a laboratory technician who accidentally inoculated himself with a biological sample taken from an Ecuadorian man with a diagnosis of histoplasmosis [106]. A third autochthonous case (described before the beginning of our study period) occurred in an immunocompromised patient treated with azathioprine in Andalusia [149]. We are not aware of any previous autochthonous cases of histoplasmosis diagnosed in Ireland, and the Israeli report (which was the first to be published in the literature) involved a patient who lived near the cave of Yodfat where H. capsulatum was isolated from bats [131,150].…”

Section: Discussionmentioning

confidence: 99%

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Antinori

Giacomelli

Corbellino

et al. 2021

JoF

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Human histoplasmosis is a mycosis caused by two distinct varieties of a dimorphic fungus: Histoplasma capsulatum var. capsulatum and H. capsulatum var. duboisii. In Europe, it is usually imported by migrants and travellers, although there have been some autochthonous cases, especially in Italy; however, most European physicians are unfamiliar with its clinical and pathological picture, particularly among immunocompromised patients without HIV infection. This systematic review of all the cases of histoplasmosis reported in Europe and Israel between 2005 and 2020 identified 728 cases diagnosed in 17 European countries and Israel described in 133 articles. The vast majority were imported (mainly from Central and South America), but there were also seven autochthonous cases (six in Europe and one in Israel). The patients were prevalently males (60.4%), and their ages ranged from 2 to 86 years. The time between leaving an endemic region and the diagnosis of histoplasmosis varied from a few weeks to more than 40 years. Progressive disseminated histoplasmosis was the most frequent clinical picture among people living with HIV infection (89.5%) or a different immunocompromising condition (57.1%), but it was also recorded in 6.2% of immunocompetent patients. Twenty-eight cases were caused by Histoplasma duboisii. Immunocompromised patients without HIV infection had the worst outcomes, with a mortality rate of 32%.

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Section: Discussionmentioning

confidence: 99%

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Antinori

Giacomelli

Corbellino

et al. 2021

JoF

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“…The second case exemplifies DH due to endogenous reactivation in the setting of therapeutic immunosuppression. Both prednisone and azathioprine have been implicated in cases of DH, including those with underlying vasculitis [21] , [22] , [23] . This patient exhibited clinical evidence of dissemination in the form of progressive cytopenias and alteration of sensorium, findings attributable to bone marrow and CNS involvement, respectively.…”

Section: Discussionmentioning

confidence: 99%

Update on the spectrum of histoplasmosis among hispanic patients presenting to a New York City municipal hospital: A contemporary case series

Gandhi

Ulyanovskiy

Epelbaum

2015

Respiratory Medicine Case Reports

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Histoplasma capsulatum is the most common endemic mycosis worldwide. Although most of the globe's largest urban hubs fall outside this organism's regions of endemicity, clinicians practicing in a metropolis like New York City or Los Angeles must nevertheless remain vigilant for histoplasmosis because of the large immigrant population that is served by its hospitals. H. capsulatum infection ranges from asymptomatic pulmonary infection to life-threatening diffuse pneumonia with dissemination. The early years of the AIDS epidemic first introduced U.S. clinicians working in areas previously unfamiliar with histoplasmosis to newly immunocompromised patients from endemic regions presenting with disseminated H. capsulatum originally acquired in their home countries. Improvement in HIV prevention and therapeutics has reduced the frequency of such cases. Herein we report three cases of histoplasmosis encountered in our New York City institution over the last three years to emphasize that awareness of this infection remains mandatory for the frontline urban clinician.

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“…This is consistent with the isolation of H. capsulatum in the soil [129] and dogs [130] in the Po Valley area in Italy and with the histoplasmin positivity rate of 1.2% in the population of this area. Few sporadic cases of autochthonous histoplasmosis have also been described in Spain [131].…”

Section: Distribution and Burden Of The Diseasementioning

confidence: 99%

Epidemiology of Histoplasmosis

Efrim¹,

Dumea²,

Cernat³

2023

Infectious Diseases

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More prevalent than initially considered, histoplasmosis is primarily a non-contagious disease of the reticuloendothelial system, producing a broad spectrum of clinical manifestations, ranging from asymptomatic or self-limited infection, in immunocompetent patients to life-threatening, disseminated disease in immunocompromised ones. The causative agent is H. capsulatum, a thermally dimorphic, intracellular fungus, discovered in 1906, by the pathologist Samuel Darling, when examined tissues from a young man whose death was mistakenly attributed to miliary tuberculosis. Since then, histoplasmosis was described on six continents, with high and low endemicity areas. H. capsulatum is a soil-based fungus, commonly associated with river valleys in the temperate zone, and with the presence of bird and bat guano. Infection occurs when saprophytic spores are inhaled and change to the pathogenic yeast in the lungs, where H. capsulatum overcomes many obstacles to cause host injuries. Depending on geographic distribution, morphology, and clinical symptoms, three varieties have been historically recognized, two of them (var. capsulatum and var. duboisii) being pathogen to humans, and the third (var. farciminosum) has predominantly been described as an equine pathogen. In endemic areas, patients with AIDS or people who receive immunosuppressive therapies should be counseled to avoid high-risk activities; otherwise, precautionary measures should be taken.

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Disseminated histoplasmosis successfully treated with liposomal amphotericin B following azathioprine therapy in a patient from a nonendemic area

Cited by 12 publications

References 9 publications

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Histoplasmosis Diagnosed in Europe and Israel: A Case Report and Systematic Review of the Literature from 2005 to 2020

Update on the spectrum of histoplasmosis among hispanic patients presenting to a New York City municipal hospital: A contemporary case series

Epidemiology of Histoplasmosis

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