Medical Case Reports

Description

In healthy people, histoplasmosis capsulatum infection can cause unusual symptoms like laryngeal involvement and chronic cavitary pulmonary disease. Fibro-cavitary lesions have been reported as a radiologic sign of chronic histoplasmosis in patients who already had lung disease. However, only a few cases have included extensive basal predominant cavitary lesions that resemble cystic bronchiectasis. Disseminated histoplasmosis, which typically affects immune-compromised individuals and affects one in every two people infected with the parasite, is uncommon. Granulomas are a sign of histoplasmosis, but they can also be found in sarcoidosis and other diseases. Granulomas are a pathological sign. Due to their similarities; disseminated histoplasmosis can be diagnosed and treated later. Because Disseminated Histoplasmosis (DH) frequently resembles other diseases, incorrect diagnoses and treatment delays are common. Our patient developed DH after receiving immune suppressant treatment for an initial diagnosis of Inflammatory Bowel Disease (IBD).After it was determined that she had DH; liposomal amphotericin B was administered to her. She eventually made a full recovery from her long hospital stay. In many ways, IBD and intra-abdominal histoplasmosis are the same thing. When immune suppressants are used to treat undiagnosed histoplasmosis, dissemination can occur, which could have devastating effects. Although the disease that defines AIDS, Acute Disseminated Histoplasmosis (ADH), has been reported in Cameroon, little is known about its prevalence. In a descriptive cross-sectional study from June to August 2019, we used the Histoplasma urine antigen detection Enzyme Immunoassay (EIA) and the histoplasmin skin test to check adults with HIV for histoplasmosis, regardless of CD4 T-cell counts.

Antigenuria from Histoplasma

With an OD cutoff of 0.045, antigen could be detected in the urine of 36 (26%) of the 138 participants who were screened. Skin lesions were present in 6% of the cases. The histoplasmin skin test revealed a positive result for one patient out of 39.Histoplasma antigenuria was associated with a positive history of chest infections (Odds ratio:3.632, 95% confidence interval:1.635–8.071, p=0.001). Since 30 titres, or 21.7%, were within the current cutoff range of 0.045 and 0.25, Cameroon's cutoff may need to be adjusted for disease confirmation using alternative, highly sensitive diagnostic methods such as PCR and bone marrow examination. Patients with HIV who attend the outpatient clinics at Buea Regional Hospital appear to be more likely to contract H. capsulatum. HIV patients need to be made more aware of their condition and treated more effectively in relation to H. capsulatum infection. Histoplasmosis typically presents with constitutional and pulmonary symptoms. Clinical manifestations include pneumonia and equivocal constitutional symptoms. The fact that it appears as a mass in the neck is unusual. This report details the admission of a 13-year-old girl with a growing mass in her neck. Histoplasma was not found in the blood or urine, but complement fixation, a positive chest CT scan, histological analysis, and a history of recent travel led to the diagnosis of Histoplasma. The goal of this report is to highlight diagnostic procedures that can be used to catch a case like this before it goes unnoticed. Adrenal Insufficiency (AI) can lead to fatal outcomes if not diagnosed promptly. This article discusses an unusual case of AI brought on by Disseminated Histoplasmosis (DH) and the significance of being aware of the link between infections and AI.

Histoplasmosis is one of the most common endemic mycoses that affect immune-compromised people in Latin America and the United States. The involvement of the central nervous system is associated with higher mortality rates and a worse prognosis due to its similarity to stroke, vasculitis, and meningitis of other etiologies. The diagnosis is difficult because of the subtle clinical presentation and the low sensitivity of the cerebrospinal fluid culture. This case involves a middle-aged man who was HIV-positive and presented with intermittent headaches that were exacerbated by an oculomotor nerve palsy, which raised concerns about an acute stroke. After treatment began and a diagnosis of central nervous system histoplasmosis was made, his neurological impairments subsided. The stroke-like syndrome may be brought on by granulomatous vasculitis of small cerebral blood vessels in this scenario. It is still difficult to diagnose central nervous system histoplasmosis, so clinicians must have a high degree of suspicion in order to start treatment early and improve outcomes. Histoplasmosis is a fungal infection caused by Histoplasma capsulatum, and only a few cases have been reported from India's northwest. Adrenal histoplasmosis is a mycotic disease that is even less common. Five immune-compromised men with adrenal histoplasmosis and constitutional symptoms are described. Four patients had bilateral adrenal involvement, while one patient had a unilateral adrenal mass. Three patients presented with adrenal insufficiency at presentation; during follow-up, two additional patients developed adrenal insufficiency. Itraconazole and amphotericin B were administered to each patient, which alleviated their symptoms but left them all with adrenal insufficiency at the conclusion of the follow-up.

Histoplasmosis disseminated

Histoplasmosis, the most common endemic mycosis in the United States, is caused by the bacterium Histoplasma capsulatum. Typically, pulmonary histoplasmosis is the symptomatic form of an infection. The infection frequently goes away on its own. In its most severe form, disseminated infection caused by H. capsulatum can spread to sites outside of the lungs.An unusual case of CNS histoplasmosis in which bilateral focal multiple spinal cord lesions alone caused bilateral lower extremity paresis and sensation loss is described here. Despite its rarity, CNS histoplasmosis ought to be included in the differential diagnosis of meningitis, encephalitis, and isolated brain or spinal cord lesions in endemic regions. Histoplasmosis is brought on by the organism Histoplasma capsulatum. Like the majority of fungal infections, histoplasmosis frequently affects patients with compromised immune systems. In immune-competent patients, infection rarely develops into a disseminated form and typically does not cause symptoms. At this time, a disseminated form of the Addisonian crisis has been reported. A disseminated histoplasmosis diagnosis of disseminated histoplasmosis in an elderly immune-competent Indian patient led to hypercalcemia and a life-threatening adrenal crisis. The appropriate diagnosis and antifungal and steroid treatment result in significant improvement for the patient. Histoplasmosis should be considered when adrenal involvement is present in immune-compromised hosts. Hypercalcemia and weight loss in a renal transplant patient who has had a parathyroidectomy in the past raise concerns about granulomatous disease, fungal infections, or cancer. In this instance, severe and persistent hypercalcemia, acute kidney injury (AKI), and significant weight loss are the symptoms that a 45-year-old man with a history of subtotal parathyroidectomy presents with.

After extensive testing, disseminated histoplasmosis was discovered. The hypercalcemia and other symptoms that were resistant to the initial medical treatment disappeared after a few weeks of starting the antifungal treatment. Histoplasmosis, a fungal infection caused by Histoplasma capsulatum, has a poor prognosis once it spreads, especially in patients with compromised immune systems. A 50-year-old Japanese-Brazilian man with multiple cervical lymphadenopathies was diagnosed with disseminated histoplasmosis and acquired immunodeficiency syndrome .Antifungal treatment came after Antiretroviral Therapy (ART).He was able to enter long-term remission thanks to treatment with voriconazole. This case report details the long-term survival in a non-endemic region of an AIDS patient with disseminated histoplasmosis. Histoplasmosis is the fungal infection that is reported as the second most frequently among domestic cats in the United States. The organism frequently spreads to other organ systems following inoculation, affecting the respiratory, gastrointestinal, reticuloendothelial, skeletal, and integumentary systems as well as the ocular systems. However, histoplasmosis that manifests as a distinct granulomatous mass on an echocardiogram has never been reported in the veterinary literature.This is the first case of feline histoplasmosis showing up as a granuloma with cardiac involvement. The male domestic longhair cat, who was 6 years old, was diagnosed with tachypnea and dyspnea. A mass in the cranial mediastinum that was abutting the heart was diagnosed with two-dimensional echocardiography. Fine-needle aspirates taken from the mass showed round yeast structures that were consistent with Histoplasma spp.,based on cytology findings. During subsequent rechecks, the patient's clinical parameters, lesion size, and antigen concentrations have significantly improved following treatment with oral fluconazole.