Case report: Disseminated histoplasmosis in a renal transplant recipient from a non-endemic region
Histoplasmosis is the most common endemic fungal infection in the USA. The majority of cases are asymptomatic and have clear exposure to endemic regions. In contrast, we present an adolescent immunocompromised patient with systemic and relatively non-specific symptoms including abdominal pain, weigh...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.985475/full |
| _version_ | 1798015344781033472 |
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| author | Brian Chang Tawny Saleh Cameron Wales Lawrence Kuklinski Prerana Malla Shangxin Yang David Fuller Karin Nielsen-Saines |
| author_facet | Brian Chang Tawny Saleh Cameron Wales Lawrence Kuklinski Prerana Malla Shangxin Yang David Fuller Karin Nielsen-Saines |
| author_sort | Brian Chang |
| collection | DOAJ |
| description | Histoplasmosis is the most common endemic fungal infection in the USA. The majority of cases are asymptomatic and have clear exposure to endemic regions. In contrast, we present an adolescent immunocompromised patient with systemic and relatively non-specific symptoms including abdominal pain, weight loss, lower extremity edema, and scabbing skin lesions, without known exposure to endemic areas for histoplasmosis. Histologic analysis of gastrointestinal and skin biopsies eventually revealed a diagnosis of disseminated histoplasmosis; the patient was successfully treated with amphotericin B followed by itraconazole maintenance therapy. Ultimately, a high bar of suspicion for fungal disease must be maintained in immunosuppressed individuals even without apparent exposure history to endemic areas. This case report serves as a valuable reference for practitioners evaluating differential diagnosis of infections in immunocompromised patients. |
| first_indexed | 2024-04-11T15:32:50Z |
| format | Article |
| id | doaj.art-d7fdb4c5a5a5481aae17ca4ebee98450 |
| institution | Directory Open Access Journal |
| issn | 2296-2360 |
| language | English |
| last_indexed | 2024-04-11T15:32:50Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj.art-d7fdb4c5a5a5481aae17ca4ebee984502022-12-22T04:16:06ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-11-011010.3389/fped.2022.985475985475Case report: Disseminated histoplasmosis in a renal transplant recipient from a non-endemic regionBrian Chang0Tawny Saleh1Cameron Wales2Lawrence Kuklinski3Prerana Malla4Shangxin Yang5David Fuller6Karin Nielsen-Saines7Department of Pediatrics, UCLA Mattel Children's Hospital, Los Angeles, CA, United StatesDepartment of Pediatrics, Pediatric Infectious Disease Division, UCLA Mattel Children's Hospital, Los Angeles, CA, United StatesUCLA Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United StatesUCLA Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United StatesDepartment of Pediatrics, UCLA Mattel Children's Hospital, Los Angeles, CA, United StatesUCLA Pathology and Laboratory Medicine, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United StatesDepartment of Medicine, Infectious Diseases Division, Ronald Reagan UCLA Medical Center, Los Angeles, CA, United StatesDepartment of Pediatrics, Pediatric Infectious Disease Division, UCLA Mattel Children's Hospital, Los Angeles, CA, United StatesHistoplasmosis is the most common endemic fungal infection in the USA. The majority of cases are asymptomatic and have clear exposure to endemic regions. In contrast, we present an adolescent immunocompromised patient with systemic and relatively non-specific symptoms including abdominal pain, weight loss, lower extremity edema, and scabbing skin lesions, without known exposure to endemic areas for histoplasmosis. Histologic analysis of gastrointestinal and skin biopsies eventually revealed a diagnosis of disseminated histoplasmosis; the patient was successfully treated with amphotericin B followed by itraconazole maintenance therapy. Ultimately, a high bar of suspicion for fungal disease must be maintained in immunosuppressed individuals even without apparent exposure history to endemic areas. This case report serves as a valuable reference for practitioners evaluating differential diagnosis of infections in immunocompromised patients.https://www.frontiersin.org/articles/10.3389/fped.2022.985475/fulldisseminated histoplasmosispediatricrenal transplantimmunosuppressionpathology |
| spellingShingle | Brian Chang Tawny Saleh Cameron Wales Lawrence Kuklinski Prerana Malla Shangxin Yang David Fuller Karin Nielsen-Saines Case report: Disseminated histoplasmosis in a renal transplant recipient from a non-endemic region Frontiers in Pediatrics disseminated histoplasmosis pediatric renal transplant immunosuppression pathology |
| title | Case report: Disseminated histoplasmosis in a renal transplant recipient from a non-endemic region |
| title_full | Case report: Disseminated histoplasmosis in a renal transplant recipient from a non-endemic region |
| title_fullStr | Case report: Disseminated histoplasmosis in a renal transplant recipient from a non-endemic region |
| title_full_unstemmed | Case report: Disseminated histoplasmosis in a renal transplant recipient from a non-endemic region |
| title_short | Case report: Disseminated histoplasmosis in a renal transplant recipient from a non-endemic region |
| title_sort | case report disseminated histoplasmosis in a renal transplant recipient from a non endemic region |
| topic | disseminated histoplasmosis pediatric renal transplant immunosuppression pathology |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.985475/full |
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