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Diagnostic Approach to Rash and Fever in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Lee S. Engel, Charles V. Sanders, Fred A. Lopez
Other fungi, such as blastomycosis, histoplasmosis, coccidioidomycosis, and sporotrichosis, can also produce skin nodules [7,293]. Coccidioidomycosis is associated with travel to the desert southwest or San Joaquin Valley of central California. Likewise, travel group outbreaks of histoplasmosis have been associated with exploring bat-infested caves and visiting bird dropping-contaminated renovation sites [294]. Patients with AIDS may present with umbilicated nodules that resemble Molluscum contagiosum but are caused by Cryptococcus neoformans.
Acute Life-threatening Mediastinal Complications of Histoplasmosis
Published in Wickii T. Vigneswaran, Thoracic Surgery, 2019
Evgeny V. Arshava, John Keech, Kalpaj R. Parekh
Acute diffuse pulmonary histoplasmosis may occur after heavy exposure to pathogens during disturbance of heavily contaminated soil or in areas with large amounts of bird or bat feces. The disease is characterized by diffuse reticulonodular pulmonary infiltrates and can progress to respiratory failure and extrapulmonary dissemination.
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.
Epidemiology and Clinical Characteristics of Presumed Ocular Histoplasmosis in Olmsted County, Minnesota
Published in Ocular Immunology and Inflammation, 2022
Timothy T. Xu, Margaret M. Reynolds, David O. Hodge, Wendy M. Smith
Presumed ocular histoplasmosis syndrome (POHS) is a clinical syndrome characterized by a triad of multifocal chorioretinal scarring, peripapillary atrophy, and choroidal neovascularization (CNV) in the absence of anterior segment and vitreous inflammation. Although its precise pathogenesis remains controversial, POHS is thought to be caused by hematogenous dissemination of Histoplasma capsulatum to the choroidal circulation.1,2H. capsulatum, the most endemic mycosis in the United States (U.S.), is found predominantly in the Midwestern U.S. along the Ohio and Mississippi River valleys in soil contaminated by bat and bird droppings and is primarily acquired through inhalation of fungal spores.2,3 Symptomatic histoplasmosis occurs in only 1% of infections, typically manifesting as pulmonary disease; rarely, extrapulmonary organ involvement and systemic dissemination may occur, particularly among immunocompromised patients.4 In Minnesota, the incidence of systemic histoplasmosis is approximately 3 to 4 cases per 100,000 persons.4,5
Mediastinal lymphadenopathy: a practical approach
Published in Expert Review of Respiratory Medicine, 2021
Hariharan Iyer, Abhishek Anand, PB Sryma, Kartik Gupta, Priyanka Naranje, Nishikant Damle, Saurabh Mittal, Neha Kawatra Madan, Anant Mohan, Vijay Hadda, Pawan Tiwari, Randeep Guleria, Karan Madan
Histoplasmosis is an endemic disease in certain regions of the United States of America with a wide range of clinical presentation, ranging from a self-limiting symptomatic flu-like illness to a progressively disseminated form of the disease. Although more common in immunocompromised individuals, it has been reported in immunocompetent individuals as well [16]. In acute histoplasmosis, there may be the presence of granulomatous mediastinal lymphadenopathy [17]. Usually, mediastinal adenitis due to histoplasmosis is asymptomatic; however, clinical features may be present due to compression of the mediastinal structures by the enlarged lymph nodes [18]. The usual course of such lymph nodes is shrinkage over time. However, rarely there may be excessive fibrosis during the healing phase, which may lead to the formation of a mediastinal granuloma or fibrosing mediastinitis [18].
Endemic mycoses: epidemiology and diagnostic strategies
Published in Expert Review of Anti-infective Therapy, 2020
Andrés Tirado-Sánchez, Gloria M. González, Alexandro Bonifaz
HPL, also called HPL capsulati, caused by the dimorphic fungus and including several cryptic species of Histoplasma: H. capsulatum (sensu stricto), H. mississippiense, H. ohiense and H. suramericanum; predominates in certain regions in the Americas, although it has also been reported in different countries worldwide [20]. It has the potential to cause massive outbreaks [20,21]. Histoplasmosis is an endemic disease in different regions of the world. In the United States, the areas with the highest number of cases (incidence 6.1 cases per 100,000 inhabitants) are reported in the center and east of the country (Mississippi and Ohio River valleys) [22]. These scenarios can be changeable due to mass travel and increased connectivity. In recent years, travel to Puerto Rico, and the Caribbean countries (Trinidad, Guyana, Barbados, and the Dominican Republic) has been observed with an increased risk for histoplasmosis than traveling to endemic areas of the United States [23]. The effects of climate change and anthropogenic soil use can contribute to change in endemic regions [20].