<i>Histoplasma Capsulatum</i>
            , Lung Infection and Immunity

Horwath, Michael; Fecher, Roger; Deepe, George S.

doi:10.2217/fmb.15.25

Cited by 125 publications

(94 citation statements)

References 80 publications

(67 reference statements)

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“…Temperature appears to be the central factor that determines the form/lifestyle of the dimorphic fungi with exposure to mammalian body temperature triggering adoption of the pathogenic mode. [4][5][6][7] Yeasts of the dimorphic fungi (or Coccidoides spherules) are not efficiently eliminated by immune cells. Preventing the transition into yeasts through pharmacologic 8,9 or genetic interventions 10-13 renders dimorphic fungal pathogens avirulent indicating the necessity of the dimorphic transition for pathogenesis.…”

Section: Dimorphism and Endemicitymentioning

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: Dimorphism and Endemicitymentioning

confidence: 99%

Antifungal therapeutics for dimorphic fungal pathogens

Goughenour

Rappleye

2016

Virulence

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“…Histoplasmosis is a systemic fungal infection caused by the dimorphic fungus Histoplasma capsulatum, which has a worldwide distribution in temperate and subtropical climates and infects humans and a wide variety of mammalian species (Horwath et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Feline histoplasmosis: a case of supraorbital involvement

Souza¹,

Gremião²,

Pereira³

et al. 2015

RBCV

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Histoplasmosis is a systemic fungal infection caused by the dimorphic fungus Histoplasma capsulatum that infects humans and a wide variety of mammalian species, including cats. In Brazil only four cases of this disease were reported in domestic cats. The present study reports a case of an indoor cat, rescued from street three years ago, that developed histoplasmosis with supraorbital involvement. The cat presented sneezing, dyspnea and increased respiratory sounds and the diagnosis suspected was allergic rhinitis. Prednisolone and amoxicillin were prescribed. The patient returned to clinic after clinical signs worsened with a swelling of the right supraorbital region, unilateral left side conjunctivitis and enlarged submandibular lymph nodes. Cytology and culture revealed Histoplasma capsulatum. Initially, itraconazole (10 mg/Kg SID orally) was prescribed and due to the worsening of clinical signs, was combined amphotericin B (0.5 mg/kg SC) for two weeks. The therapy with amphotericin was discontinued and itraconazole continued to be administered for six months. The clinical signs were resolved and no recrudescence was reported. It is important that veterinary practitioners to be aware of the clinical features of feline histoplasmosis and consider the possibility of a subclinical infection.Keywords: corticosteroid, cat, involvement supraorbital, Histoplasma capsulatum. ResumoHistoplasmose é uma infecção sistêmica causada pelo fungo dimórfico Histoplasma capsulatum, que infecta humanos e uma ampla variedade de mamíferos, incluindo os gatos. No Brasil, somente quatro casos dessa doença foram relatados em gatos domésticos. O presente estudo relata um caso de um gato, vivendo em ambiente domiciliar sem acesso à rua, mas que tinha sido resgatado das ruas havia três anos, que desenvolveu histoplasmose com envolvimento supraorbital. O paciente apresentava espirros, dispneia e aumento dos sons respiratórios e a suspeita clínica foi rinite alérgica. O animal foi tratado com prednisolona e amoxicilina. Com a piora dos sinais clínicos o paciente retornou apresentando um edema na região supraorbital direita, conjuntivite unilateral do olho esquerdo e linfoadenomegalia na região submandibular. A citologia e a cultura revelaram a presença de Histoplasma capsulatum. Inicialmente, itraconazol (10 mg/kg via oral, uma vez ao dia) foi prescrito e devido à piora dos sinais clínicos, anfotericina B (0,5 mg/Kg via subcutânea) foi administrada por duas semanas associada ao triazólico. A terapia com anfotericina B foi descontinuada e o itraconazol mantido por seis meses até a cura clínica e nenhuma recrudescência foi registrada. É importante ressaltar que veterinários devem estar atentos para os sinais clínicos da histoplasmose e que devem considerar a possibilidade de uma infecção subclínica.Palavras-chave: corticoide, gato, envolvimento supraorbital, Histoplasma capsulatum.

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“…After inhalation of microconidia, majority of patients develop subclinical, self-limited and unrecognised disease. However, defects in cellular immunity results in progression of the infection, resulting in dissemination 6. Disseminated infection in this patient from an endemic area could demonstrate either primary infection or reactivation of latent infection; both resulting from recent immunocompromised state.…”

Section: Discussionmentioning

confidence: 84%

Disseminated histoplasmosis mimicking relapsed chronic lymphocytic leukaemia

Shahani¹

2018

BMJ Case Reports

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Histoplasma microconidia when inhaled are presented in antigenic form to T cells, limiting the extent of infection; however, defects in cellular immunity results in disseminated disease. Chronic lymphocytic leukaemia (CLL) is a lymphoproliferative disorder resulting in functionally impaired lymphocytes, predisposing patients to various opportunistic infections. The author reports a recently treated patient with CLL presenting with constitutional symptoms accompanied by hepatosplenomegaly and diffuse adenopathy. Considering the recent diagnosis and treatment of CLL, initial suspicion was relapsed disease. However, considering the immune deficiency associated with CLL and its treatment, infectious aetiologies were strongly considered. Further investigation revealed a case of disseminated histoplasmosis mimicking CLL in this reported patient. Considering appropriate diagnosis and timely therapy, the reported patient had good prognosis despite being diagnosed with disseminated histoplasmosis. This case highlights consideration of disseminated histoplasmosis in patients presenting with diffuse adenopathy along with hepatomegaly and/or splenomegaly in the right clinical setting.

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Histoplasma Capsulatum , Lung Infection and Immunity

Cited by 125 publications

References 80 publications

Antifungal therapeutics for dimorphic fungal pathogens

Antifungal therapeutics for dimorphic fungal pathogens

Feline histoplasmosis: a case of supraorbital involvement

Disseminated histoplasmosis mimicking relapsed chronic lymphocytic leukaemia

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