Tonsillar ulceration as manifestation of disseminated African histoplasmosis in an immunocompetent Portuguese host

Cardoso, Leila A.; Silva, C.; Marques, Nuno; Veríssimo, Cristina

doi:10.1016/j.mmcr.2017.04.003

Cited by 10 publications

(8 citation statements)

References 17 publications

(26 reference statements)

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“…There were eight cases (13.3%) of single or multiple nodular lung lesions mimicking neoplasia or severe sarcoidosis [95,97,107,[119][120][121]128,133], three cases of chronic cavitary histoplasmosis [101,102,127], and one patient with fibrosing mediastinitis [130]. Five patients (6.2%) presented with a picture of PDH [103,116,123,125,126], and two showed central nervous system involvement [103,134]. Oropharyngeal ulcerations (tongue, uvula, gingiva, tonsils, hard palate) were described in five patients, and three had primary cutaneous histoplasmosis.…”

Section: Immunocompetent Patientsmentioning

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: Immunocompetent Patientsmentioning

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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“…Oral lesions as in our baboons are well-documented in human cases of disseminated HCD [1,12,15,16,23,26]. However, oral lesions as the sole manifestation of HCD in humans are uncommon, and their status as primary localized lesions is questionable [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…Disseminated disease has a poor clinical and treatment outcome [1, 3-5, 10, 14]. There are sporadic reports of HCD within the oral cavity involving the tonsil, buccal mucosa, tongue, gingiva, maxillary and mandibular bones [1,[12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Gingival histoplasmosis: An atypical presentation of African histoplasmosis in three baboons (Papio spp)

Johannigman

González

Dutton

et al. 2019

J of Medical Primatology

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“…Generally, African histoplasmosis has not been associated with any underlying immune deficiencies or genetic defects and is common in immunocompetent patients. However, classical histoplasmosis is frequently associated with advanced human immunodeficiency virus (HIV) disease [ 15 – 22 ]. The cases reported in advanced HIV patients are mostly disseminated, with poor prognosis [ 22 – 25 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, classical histoplasmosis is frequently associated with advanced human immunodeficiency virus (HIV) disease [ 15 – 22 ]. The cases reported in advanced HIV patients are mostly disseminated, with poor prognosis [ 22 – 25 ].…”

Section: Introductionmentioning

confidence: 99%

Histoplasmosis in Africa: Current perspectives, knowledge gaps, and research priorities

et al. 2022

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Background Histoplasmosis is a chronic granulomatous disease caused by the thermally dimorphic fungus Histoplasma capsulatum. The 2 variants Histoplasma capsulatum var. capsulatum (Hcc) and Histoplasma capsulatum var. duboisii (Hcd) causes infection in humans and commonly termed classical or American histoplasmosis and African histoplasmosis, respectively. Histoplasma capsulatum var. farciminosum (Hcf) affects equines. In recent times, there have been heightened sensitization on fungal infections such as histoplasmosis in Africa, aimed at improving awareness among relevant stakeholders, particularly healthcare workers. This effort is expected to be paralleled with increased detection of both classical and African histoplasmosis, which has remained underdiagnosed over the years. In this narrative review, we describe the current perspectives of histoplasmosis in Africa, identify knowledge gaps, and suggest research priorities. Methods A PubMed, Google Scholar, and Africa Journal Online (AJOL) literature search was conducted for studies on histoplasmosis in Africa between 2000 and 2020. Histoplasmosis essays in medical mycology textbooks were also consulted. This narrative review was prepared from the data gathered. Findings In the past 2 decades, histoplasmosis in general has seen a relative increase in case detection in some Africa countries, probably attributable to the gradually increasing medical mycology advocacy efforts in Africa. Histoplasmosis cases are dominated by African histoplasmosis mostly in Western and Central Africa, while classical histoplasmosis is more common in Southern and Northern Africa. Although both classical and African histoplasmosis are common in Africa, the latter is more restricted to Africa, and cases outside the continent usually have a travel history to the continent. Despite the clinical and laboratory difference between African histoplasmosis and classical histoplasmosis, it is not straightforward to distinguish them. The typical manifestation of African histoplasmosis is the appearance of lesions affecting the skin, bones, and lymph nodes and unusually linked to human immunodeficiency virus (HIV)/AIDS. By contrast, classical histoplasmosis mostly affects the lungs and is often associated with immunosuppression, mainly HIV/AIDS. The present perspectives of histoplasmosis in Africa highlight unclear details on the true burden, strain diversity, infection route and genetic basis of African histoplasmosis, availability of specie-specific diagnostic tools, and compliance with recommended antifungal therapy. These knowledge gaps represent research questions that require scientific exploration. Conclusions Despite a subtle increase in identifying histoplasmosis cases in Africa, it remains underdiagnosed and neglected in some parts of the continent. Increasing awareness and training among healthcare workers, bridging diagnostic and therapeutic gaps, and encouraging more research in Africa are crucial to improve the current perspectives of histoplasmosis in Africa.

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Tonsillar ulceration as manifestation of disseminated African histoplasmosis in an immunocompetent Portuguese host

Cited by 10 publications

References 17 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

Gingival histoplasmosis: An atypical presentation of African histoplasmosis in three baboons (Papio spp)

Histoplasmosis in Africa: Current perspectives, knowledge gaps, and research priorities

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