Disseminated Histoplasmosis: Case Report and Review
Histoplasmosis is a systemic fungal disease. It is also called as Darling’s disease, as it was first described by an American physician named Samuel Taylor Darling, in Panama. It is caused by the dimorphic fungus Histoplasma capsulatum. It is usually self-limiting or localized in immunocompetent...
Main Authors: | , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Pvt. Ltd.
2017-07-01
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Series: | National Journal of Laboratory Medicine |
Subjects: | |
Online Access: | http://www.njlm.net/articles/PDF/2240/29265_CE[VSU]_F(AK)_PF1(VSU_KM_GG)_PFA(VSU_GG)_PF2(VSU_GG).pdf |
Summary: | Histoplasmosis is a systemic fungal disease. It is also called
as Darling’s disease, as it was first described by an American
physician named Samuel Taylor Darling, in Panama. It is caused
by the dimorphic fungus Histoplasma capsulatum. It is usually
self-limiting or localized in immunocompetent individuals
whereas in immunocompromised patients, it presents in
disseminated forms. This infection is endemic to central and
South-central United States.
Histoplasmosis infection is acquired by inhalation of fungal
microconidia present in the contaminated soil. Asymptomatic
dissemination of infection beyond the lungs is common.
Infection heals spontaneously in most of the cases and
in some cases it develops into pulmonary disease similar
to tuberculosis. Dissemination and systemic involvement
occurs in patients suffering from debilitating diseases and
immunocompromised conditions. It is relatively uncommon
in India with few sporadic cases getting reported and it is
endemic in eastern part of India. In non-endemic parts,
disseminated histoplasmosis is rarely suspected and there
have been very few case reports. Awareness is required, as
its presentation is similar to tuberculosis, especially when we
have patients with compromised immune status. We are
reporting, with consent, one such rare case of disseminated
histoplasmosis in a 36-year-old male farmer from South India
with acquired immunodeficiency syndrome and very low
CD4 count of 17cells/µl with lymph node and bone marrow
involvement. Awareness of this infection is essential in these
cases as it is potentially lethal and adequately treated patients
with antifungal agents carry better prognosis. In non-endemic
areas Disseminated Histoplasmosis has to be differentiated
from more common disease like tuberculosis, leishmaniasis or
systemic malignancies. |
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ISSN: | 2277-8551 2455-6882 |