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Acute Life-threatening Mediastinal Complications of Histoplasmosis
Published in Wickii T. Vigneswaran, Thoracic Surgery, 2019
Evgeny V. Arshava, John Keech, Kalpaj R. Parekh
Most infections with Histoplasma capsulatum are either asymptomatic or do not require treatment even in endemic regions. Acute complications of histoplasmosis requiring surgical interventions are rare but need to be diagnosed promptly and treated aggressively.
Basic science, investigations and lasers
Published in Mostafa Khalil, Omar Kouli, The Duke Elder Exam of Ophthalmology, 2019
Tarek Khalil, Bilal Ibrahim, Stewart Gillan, Obaid Kousha
These fungi have properties of both yeasts and filamentous fungi. Histoplasma capsulatum is a soil fungus, endemic in Mississippi and Ohio River Valleys. Transmission is via inhalation. It can cause presumed ocular histoplasmosis syndrome (POHS).
Disseminated Histoplasmosis, Coccidioidomycosis, And Cryptococcosis
Published in Lourdes R. Laraya-Cuasay, Walter T. Hughes, Interstitial Lung Diseases in Children, 2019
Histoplasma capsulatum causes a variety of self-limited illnesses in the otherwise normal host. However, in the immunocompromised individual systemic dissemination may occur involving more than one organ system. Those at highest risk for disseminated histoplasmosis are residents in the endemic areas of the southeast, south central, and midwestern states who are immunosuppressed because of cancer chemotherapy, organ transplantation, congenital immune deficiency disorders, acquired immunodeficiency syndrome (AIDS), and in infants with immature immunity. Occasionally, the disseminated infection occurs in persons with no discernible immune defect and in nonendemic areas.
Spontaneous pneumothorax secondary to chronic cavitary pulmonary histoplasmosis
Published in Journal of Community Hospital Internal Medicine Perspectives, 2020
Histoplasma capsulatum is a dimorphic fungus that is classically endemic to the Midwestern and Central USA [1]. This includes the Mississippi and Ohio River Valleys in which parts of North Texas are included [2]. It typically enters hosts through the respiratory tract and only causes symptoms in a small number of patients [3]. Infection with Histoplasma capsulatum, termed histoplasmosis, can present in a variety of ways, including both acute and chronic forms. Symptoms are somewhat non-specific, and include chest pain, productive cough, dyspnea, fever, and fatigue [3]. Chronic cavitary pulmonary histoplasmosis is one of the rarest presentations of histoplasmosis, and typically manifests as apical cavitary lesions in patients with pre-existing chronic obstructive pulmonary disease [3]. These apical cavitary lesions are frequently mistaken for malignancy or pulmonary tuberculosis. It is important to remember that chronic pulmonary infection with Histoplasma capsulatum can cause apical cavitary lung disease, it is often misdiagnosed, and lack of appropriate treatment portends a poor prognosis [4,5].
Rash decisions can be life-saving: a case of disseminated histoplasmosis in an immunocompromised patient
Published in Journal of Community Hospital Internal Medicine Perspectives, 2019
Huda Naz Khan, Stephen L. Hines, Leigh Hunter
In the environment, Histoplasma capsulatum exists as a mold with hyphae, which produce spores that are aerosolized and dispersed. Once inhaled by the susceptible host, the spores transform into budding yeast in warmer climates. The yeast forms are then phagocytized by macrophages, which assist in spreading the organism to various parts of the body. Once host cellular immunity to Histoplasma develops, the macrophages become activated to kill the organism. In immunocompetent patients, these defense mechanisms are usually sufficient to control the infection. Patients who develop the progressive, disseminated form of histoplasmosis generally have an underlying condition impairing their ability to defend against these intracellular pathogens. Risk factors for the disseminated disease include extremes of age, diagnosis of AIDS, hematologic malignancy, history of transplantation, treatment with immunosuppressive agents, and congenital T-cell deficiencies [1]. In our case, the patient was immunocompromised by both diabetes mellitus and decompensated cirrhosis due to hemochromatosis.
Endemic pulmonary fungal diseases in immunocompetent patients: an emphasis on thoracic imaging
Published in Expert Review of Respiratory Medicine, 2019
Ana Luiza Di Mango, Gláucia Zanetti, Diana Penha, Miriam Menna Barreto, Edson Marchiori
Histoplasmosis is a community-acquired infection caused by Histoplasma capsulatum (H. capsulatum), a ubiquitous soil-inhabiting dimorphic fungus. This fungal infection, has a worldwide incidence, except in some Europe countries, and is the most common endemic pulmonary mycosis in the United States and in several countries of Central and South America. It also occurs in Asia, Africa, India, and China. A variety of the fungus that can also cause lung involvement (H. capsulatum var. duboisii) was described in African patients” [14]. The distribution of H. capsulatum in the environment varies and the activities most commonly related to exposure include farming, exposure to chicken coops or caves contaminated with bat excrements, demolition of old buildings and decaying trees [15–19]. The primary portal of entry is the respiratory tract. Following inhalation of spores, H. capsulatum transforms into the pathogenic yeast. The host’s main defense against the infection is the development of cell-mediated immunity, particularly the Th1 response. The production of tumor necrosis factor ‘alpha’ and interferon gamma activates macrophages with phagocytose of the organism inhibiting its growth. With the HIV pandemic and the increasing number of patients receiving immunosuppressive therapies, the population at risk for histoplasmosis will continue to grow [15,16,20].