Histoplasmosis Complicating Tumor Necrosis Factor–α Blocker Therapy: A Retrospective Analysis of 98 Cases

Vergidis, Paschalis; Avery, Robin K.; Wheat, L. Joseph; Dotson, Jennifer L.; Assi, Maha; Antoun, Smyrna Abou; Hamoud, Kassem A.; Burdette, Steven D.; Freifeld, Alison G.; McKinsey, David S.; Money, Mary E.; Myint, Thein; Andes, David R.; Hoey, Cynthia; Kaul, Daniel R; Dickter, Jana; Liebers, David E.; Miller, Rachel; Muth, William E.; Prakash, Vidhya; Steiner, Frederick T.; Walker, Randall C.; Hage, Chadi A.

doi:10.1093/cid/civ299

Cited by 120 publications

(90 citation statements)

References 22 publications

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“…Elimination of symptoms has been assumed to indicate clearance of the infection, but evidence is now suggesting that at least in some individuals, the infection can enter a latent state, which can re-emerge later when the balance between pathogen and host immunity is altered (e.g., immunosuppression of the host). [50][51][52][53][54][55][56] Since inhalation is the route of exposure, mycoses caused by dimorphic fungal pathogens are initially pulmonary diseases. In immunocompetent individuals, mild disease is mostly subclinical, often going undiagnosed.…”

Section: Dimorphic Fungal Pathogen Disease and Treatmentmentioning

confidence: 99%

Antifungal therapeutics for dimorphic fungal pathogens

Goughenour

Rappleye

2016

Virulence

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Dimorphic fungi cause several endemic mycoses which range from subclinical respiratory infections to life-threatening systemic disease. Pathogenic-phase cells of Histoplasma, Blastomyces, Paracoccidioides and Coccidioides escape elimination by the innate immune response with control ultimately requiring activation of cell-mediated immunity. Clinical management of disease relies primarily on antifungal compounds; however, dimorphic fungal pathogens create a number of challenges for antifungal drug therapy. In addition to the drug toxicity issues known for current antifungals, barriers to efficient drug treatment of dimorphic fungal infections include natural resistance to the echinocandins, residence of fungal cells within immune cells, the requirement for systemic delivery of drugs, prolonged treatment times, potential for latent infections, and lack of optimized standardized methodology for in vitro testing of drug susceptibilities. This review will highlight recent advances, current therapeutic options, and new compounds on the horizon for treating infections by dimorphic fungal pathogens.

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Section: Dimorphic Fungal Pathogen Disease and Treatmentmentioning

confidence: 99%

Antifungal therapeutics for dimorphic fungal pathogens

Goughenour

Rappleye

2016

Virulence

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“…Another important risk factor for both mycoses, particularly, histoplasmosis, is treatment with immunomodulators, such as TNF-α [14,15]. In this study, 2 patients had been treated whit these drugs.…”

Section: Discussionmentioning

confidence: 97%

Oral Manifestations Associated to Paracoccidioidomicosis and Histoplasmosis

Merino-Alado

Mata-Essayag

Pineda

et al. 2018

Pesqui. bras. odontopediatria clín. integr.

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Objective: To determine the frequency and clinical forms of oral manifestations associated to Paracoccidioidomycosis (PCM) and Histoplasmosis. Material and Methods: 481 medical records of outpatients referred to the Medical Mycology Department were reviewed since 2009 to 2016. Data were analyzed using descriptive statistical methods. Results: 47 (9.77%) cases had oral manifestations, 29 (61.70%) were associated to PCM and 18 (38.29%) to histoplasmosis. For PCM, male-female ratio was 8:1 and 1:1 for histoplasmosis. The average age for PCM was 48 years old and 53 for histoplasmosis. All the PCM patients had more than 1 oral structure affected: 44.82% were gingival lesions and 27.58% palate. In patients with histoplasmosis, 6 (33.33%) were lesions affecting palate and 6 (33.33%) involving tongue. For both entities, painful ulcers and granulomatous-like lesions were the most prevalent clinical forms; however, we observed a wide range of other oral manifestations. Regarding PCM patient's comorbidities, 3 (10.34%) cases had HIV/AIDS, 8 (27.58%) histoplasmosis and 2 (6.89%) carcinomas. Whereas the comorbidities of patients with histoplasmosis, 2 (11.11%) had HIV/AIDS and 1 (5.55%) had carcinoma. Conclusion: In endemic countries for both mycoses, dentists must be aware of patients with mouth lesions, take advantage of epidemiologic clues that suggest risk factors and be acquainted with all the current diagnostic tests in order to make a quick diagnosis and treatment in highly suspicious cases.

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“…Заболевание широко распростране-но в Африке и отдельных регионах Северной Америки (осо-бенно в штате Огайо и долине реки Миссисипи). Описано более 100 случаев развития этой инфекции у больных с РЗ на фоне лечения ИНФ, АДА и ЭТЦ [17,18].…”

Section: возбудители -эндемичные диморфные грибыunclassified

Mycotic infections in rheumatology

Белов¹,

Тарасова²,

Буханова³

2017

RJTAO

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Invasive mycoses are becoming a more relevant problem in modern rheumatology. There are difficulties in the lifetime diagnosis and treatment of mycoses in patients with rheumatic diseases. The significance of this issue increases considerably due to the active clinical introduction of biological agents. The paper provides general information on the clinical presentation, diagnosis, and therapy of the most common mycoses.

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Histoplasmosis Complicating Tumor Necrosis Factor–α Blocker Therapy: A Retrospective Analysis of 98 Cases

Cited by 120 publications

References 22 publications

Antifungal therapeutics for dimorphic fungal pathogens

Antifungal therapeutics for dimorphic fungal pathogens

Oral Manifestations Associated to Paracoccidioidomicosis and Histoplasmosis

Mycotic infections in rheumatology

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