Importance of multidisciplinary approach in diagnosis of histoplasmosis

Abstract

A patient with systemic involvement, initially treated as tuberculosis, is presented in this report. There were only two painful subcutaneous nodules, from which we arrived at the correct diagnosis of histoplasmosis. The patient was attended by several experts in the fields of infectious diseases, nephrology and internal medicine, but the diagnosis was only possible after dermatological examination and skin biopsy. This case values multidisciplinary interaction between dermatologists and other medical areas for diagnosis of cases with atypical manifestations.

Clinical Characteristics and Outcomes of Endemic Mycoses After Solid Organ Transplantation: A Comprehensive Review

“…There were 172 cases of histoplasmosis described in 125 reports [ 66 , 69 , 72–87 , 90–99 , 101–182 , 194 , 196 , 197 , 199–206 , 208 , 241–243 ] ( Table 1 ). Half of recipients (74 of 144 [51.4%]) were on MMF [ 73 , 74 , 80 , 83–86 , 92–94 , 96 , 98 , 101–104 , 107–109 , 113–116 , 118–120 , 122 , 126 , 130 , 132–135 , 140 , 143 , 145 , 148–150 , 152 , 153 , 155 , 156 , 159 , 161–165 , 172–174 , 177 , 179 , 181 , 194 , 196 , 197 , 204 ]. T-cell–depleting induction was reported in 23 cases [ 78 , 104 , 107 , 108 , 110 , 113–115 , 118 , 125 , 133 , 146 , 154 , 163 ] while acute rejection occurred in 30 recipients within 1–3 months before symptom onset […”

Histoplasmosis: An Overview Treatment of Histoplasmosis

“…These distinct clinical syndromes vary by clinical course and wide range of presentation, degrees of severity, extent of disease, delay of diagnosis, and radiographic findings. Therefore, treatment depends on the severity of the clinical syndrome as well as the host immune status [11,13].…”