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Clinical,biochemical and imaging characteristics of adrenal histoplasmosis in immunocompetent patients in a non-endemic area:A case series

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Asian Pacific Journal of Tropical Medicine 2021年第10期14卷 471-477页

作者： Sharmin Jahan Tahseen Mahmood Md Fariduddin Ibrahim Faisal Md Shahed Morshed Anil Yadav Anil Kumar Shah Chomon Abdullah Emran-Ur-Rashid Chowdhury Ferdousi Begum MA Hasanat Department of Endocrinology Bangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh Department of Endocrinology Combined Military HospitalDhaka CantonmentDhakaBangladesh Division of Endocrinology Department of Internal MedicineIndira Gandhi Memorial HospitalKanbaa Aisa Rani HigunMale'-20402Republic of Maldives Department of Emergency Kurmitola General HospitalDhakaBangladesh Division of Endocrinology Department of Internal Medicine Birat Medical College Teaching HospitalBiratnagarNepal Division of Endocrinology Department of Internal MedicineChitwan Medical CollegeChitwan 44300Nepal Department of Pathology Bangabandhu Sheikh Mujib Medical UniversityDhakaBangladesh

Objective:To document the clinical,biochemical and imaging phenotypes of immunocompetent patients with adrenal ***:The clinical,biochemical and radiologic data of 18 immunocompetent patients[age:45.00(39.25,56.25)years,median(IQR),m/f(16/2)]with adrenal histoplasmosis presenting in the Department of Endocrinology,BSMMU between 2014 and 2020 were retrospectively ***:All patients were seronegative for HIV infection,and 27.8%(5/18)had well controlled diabetes *** median duration of the symptoms was 6.00(IQR:4.00,11.25)*** had significant weight loss,anorexia and *** was present in 61.1%(11/18)patients and night sweat was present in 27.8%(5/18)*** and hyperpigmentation were present in 55.6%(10/18)and 66.7%(12/18)cases,*** of 18 patients presented with adrenal *** occurred in 55.6%(10/18)cases,but none had *** of 18 patients had adrenal insufficiency whereas 83.3%(15/18)had high adrenocorticotropic *** scan revealed bilateral adrenal enlargement in all cases with oval shape and regular *** were hypodense having radiodensity 21-90 hounsfield unit,and 11.1%(2/18)were heterogeneous in contrast *** had noticeable calcification whereas 1.1%(2/18)cases had central necrosis with peripheral rim *** was present in 6 cases,splenomegaly in 3 cases and 5 patients had abdominal *** were confirmed by positive fine needle aspiration cytology of adrenal ***:Adrenal histoplasmosis should be considered in the list of differentials of bilateral adrenomegaly in immunocompetent individuals even living in non-endemic areas.

关键词： histoplasmosis Immunocompetent Nonendemic Adrenal CT

Fatal gastrointestinal histoplasmosis 15 years after orthotopic liver transplantation

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World Journal of Gastroenterology 2017年第43期23卷 7807-7812页

作者： Nikita Agrawal David EJ Jones Jessica K Dyson Tim Hoare Sharon A Melmore Stephanie Needham Nick P Thompson Department of Gastro-enterology Newcastle Hospitals NHS Foundation TrustNewcastle Upon Tyne NE7 7DNUnited Kingdom Faculty of Medical Sciences Newcastle UniversityNewcastle Upon Tyne NE7 7DNUnited Kingdom Department of Radiology Newcastle Hospitals NHS Foundation TrustNewcastle Upon Tyne NE7 7DNUnited Kingdom Department of Histopathology Newcastle Hospitals NHS Foundation TrustNewcastle Upon Tyne NE7 7DNUnited Kingdom

We report a case of ileo-colonic histoplasmosis without apparent respiratory involvement in a patient who had previously undergone an orthotopic liver transplant(OLT) for primary biliary cholangitis 15 years earlier. The recipient lived in the United Kingdom,a non-endemic region for histoplasmosis. However,she had previously lived in rural southern Africa prior to her OLT. The patient presented with iron deficiency anaemia,diarrhoea,abdominal pain and progressive weight loss. She reported no previous foreign travel,however,it later became known that following her OLT she had been on holiday to rural southern Africa. On investigation,a mild granulomatous colitis primarily affecting the right colon was identified,that initially improved with mesalazine. Her symptoms worsened after 18 mo with progressive ulceration of her distal small bowel and right colon. Mycobacterial,Yersinia,cytomegalovirus and human immunodeficiency virus infections were excluded and the patient was treated with prednisolone for a working diagnosis of Crohn's disease. Despite some early symptom improvement following steroids,there was subsequent deterioration with the patient developing gram-negative sepsis and multi-organ failure,leading to her death. Post-mortem examination revealed that her ileo-colonic inflammation was caused by histoplasmosis.

关键词： histoplasmosis Orthotopic liver transplant Primary biliary cholangitis Primary biliary cholangitis

Hepatic histoplasmosis: An Update

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Journal of Clinical and Translational Hepatology 2022年第4期10卷 726-729页

作者： Maimuna Sayeed Md Benzamin Luthfun Nahar Masud Rana Aisharza Sultana Aishy Department of Paediatric Gastroenterology&Nutrition Bangabandhu Shiekh Mujib Medical University(BSMMU)DhakaBangladesh Hazi Asmot Ali Medical Centre BhairabKishoregonjDhakaBangladesh Jalalabad Ragib-Rabeya Medical College SylhetBangladesh

Histoplasma capsulatum is the most common cause of en-demic mycosis in developing countries. It is a self-limited and asymptomatic disease in immunocompetent individu-als but remains a frequent cause of opportunistic infection in patients with compromised immune status. Liver in-volvement as a part of disseminated histoplasmosis is well known. However, liver infection as a primary manifestation of histoplasmosis without evidence of primary lung involve-ment is rare. In conclusion, clinicians should be aware of isolated histoplasmosis affecting the hepatobiliary system, and careful evaluation is warranted to confirm the diagno-sis. Given the appropriate clinical context, histoplasmosis should be considered in both immunocompetent and immu-nocompromised patients, regardless of pulmonary symp-toms, in non endemic as well as endemic areas.

关键词： Histoplasma capsulatum histoplasmosis Hepatic manifestation Mycosis

Disseminated histoplasmosis in a 17-year-old Nigerian male patient:A case report

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Asian Pacific Journal of Tropical Medicine 2022年第6期15卷 283-286页

作者： Atana Uket Ewa Bassey Ewa Ekeng Glory Ekpo Bassey Enobong Ufot Akpah Osamagbe Aiyudubie Asemota Livinus Nwancho Nweke Department of Paediatrics University of CalabarCalabarNigeria Department of Paediatrics University of Calabar Teaching HospitalCalabarNigeria Medical Mycology Society of Nigeria Department of Medical Microbiology and Parasitology University of Calabar Teaching HospitalCalabarNigeria

Rationale:Disseminated histoplasmosis is the most severe form of histoplasmosis and often associated with fatal *** pulmonary and disseminated forms mimics tuberculosis(TB)and may be *** concerns:A 17-year-old male patient compliant with anti-tuberculosis therapy with complaints of fever,cough productive of thick yellowish sputum,fast breathing,abdominal pain,swelling and *** status was ***:Disseminated ***:Antimicrobials including anti-TB therapy,ceftriaxone,gentamicin,azithromycin and ***:He was responding to anti-TB drugs until about 4 and a half months on treatment when he fell *** blood film done 2 days prior to his demise revealed florid yeast like organisms in monocytes with eccentric chromatin suggestive of Histoplasma ***:histoplasmosis can both mimic and coexist with TB and so a high index of suspicion is needed for its diagnosis.

关键词： histoplasmosis Disseminated Tuberculosis Sepsis Case report

Oozing sub-cutaneous masses due to histoplasmosis in a patient from Mali

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Asian Pacific Journal of Tropical Medicine 2010年第2期3卷 158-159页

作者： Yann A.Meunier Stanford Health Promotion Network Stanford School of Medicine

We presented the case of a 64 year old from Mali who was admitted to the hospital for "oozing sub-cutaneous masses".The diagnosis of African histoplasmosis was established by serology. Several courses of amphotericin ... 详细信息

关键词： Oozing Sub-cutaneous Masses Mali African histoplasmosis

histoplasmosis and inflammatory bowel disease: A case report

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World Journal of Gastrointestinal Endoscopy 2021年第1期13卷 24-32页

作者： Dushyant Dahiya Asim Kichloo Jagmeet Singh Michael Albosta Farah Wani Internal Medicine Central Michigan UniversitySaginawMI 48603United States Internal Medicine Samaritan Medical CenterWatertownNY 13601United States Internal Medicine Guthrie Robert Packer HospitalSayrePA 18840United States

BACKGROUND Infection with Histoplasma capsulatum can lead to a disseminated disease involving the gastrointestinal tract presenting as diffuse abdominal pain and inflammatory diarrhea which may mimic inflammatory bowel disease(IBD).CASE SUMMARY In the current report,we discuss the case of a 41-year old male who presented to the emergency department with complaints of high-grade intermittent fevers and severe abdominal pain with associated diarrhea and *** results demonstrated transaminitis and elevated erythrocyte sedimentation rate,C-reactive protein and ferritin *** patient’s presentation was thought to be an exacerbation of his underlying IBD,but further investigations revealed a positive Histoplasma antigen in the *** patient was offered a colonoscopy and biopsy to confirm the diagnosis;however,he *** was treated with itraconazole and showed significant improvement of his symptoms,thereby confirming the diagnosis of gastrointestinal *** Here within,we provide a review of IBD,evaluation of chronic diarrhea,and gastrointestinal histoplasmosis.

关键词： histoplasmosis Inflammatory bowel disease Intestine Endoscopy Gastroenterology Case report

Primary histoplasmosis of Larynx: A Case Series and Review of Literature

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International Journal of Otolaryngology and Head & Neck Surgery 2013年第2期2卷 47-51页

作者： Nishi Sonkhya Raghav Mehta Divij Sonkhya Shubha Gupta Mansi Faujdar Department of Ear Nose and Throat N.K.P. Salve Institute & Lata Mangeshker Hospital Jaipur India Department of Ear Nose and Throat S.M.S. Medical College and Hospital Jaipur India S.D.M. Hospital Jaipur India

Objective: Aim of the study was to analyze 10 managed cases of Primary histoplasmosis of Larynx, over a period of 10 years. Design: Retrospective, non-randomized, interventional case series. Patients and Method: This study was conducted in the Department of Otorhinolaryngology S.M.S Medical College from 2002 to 2011. The study consisted of evaluation of self-reported and referred patients who presented to ENT OPD and emergency. In all the cases a detailed history and clinical examination was done. All the patients underwent fiber optic laryngoscopy and subsequent direct laryngoscopy and biopsy. CT Scans were obtained for few cases. The study was a retrospective analysis of 10 treated cases. Main Outcome and Measures: Success of the treatment was defined as resolution of symptoms, differ-entiation from malignancy, no recurrence and regular follow up. Result: A total of 10 cases were managed between 2002 and 2011 and were reviewed. The main presentation was hoarseness of voice, with lesion simulating malignancy. Most common site of involvement was false cord and aryepiglottic fold (6 cases). Primary laryngeal histoplasmosis was essentially a disease of adult males in all 10 cases. Treatment was exclusively medical with use of Itraconazole as drug of choice in 7 cases. Conclusion: Isolated laryngeal histoplasmosis is a rare entity. Because of its simulation with malignancy it needs to be included in the differential diagnosis of neoplasm both benign and malignant. Our study clearly limits this kind of disease to adult males most commonly involving false cord and aryepiglottic fold in an endophytic pattern. Though it looks like cancer;biopsy confirms the diagnosis. The treatment is mainly medical with Itraconazole being the drug of choice.

关键词： Laryngeal histoplasmosis Histoplasma Capsulatum Laryngeal Malignancy

Non habitual microscopic forms of Histoplasma capsulatum in disseminated disease

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Asian Pacific Journal of Tropical Medicine 2008年第2期1卷 28-30页

作者： Bava AJ Garro S Troncoso A University of La Plata Argentina Department of Infectious Diseases "Francisco J.Mutiiz" HospitalBuenos AiresArgentina School of Medicine University of Buenos AiresArgentina

This paper communicates the presence of aberrant microscopic forms of Histoplasma capsulatum in a sample obtained by scrapping of the skin lesion and stained with a rapid modification of the Grocott *** AIDS patient was treated with cream contained corticoids and antifungal and antibacterial antibiotics by an erroneous *** the etiologic diagnosis was achieved,oral itraconazol was administrated at the daily dose of 400 mg during at least six *** non habitual forms described in the literature as " aberrant variants", can be interpreted as an "adaptive phenomenon" of this termodimorphic fungal specie,as response of the ecologic alterations produced by antibiotic on the local antagonic bacterial microbiota,the deleterous activity of antifungal on the fungal cells and the local inmunodepression produced by the corticoids.

关键词： aberrant Histoplasma capsulatum AIDS associated histoplasmosis Endemic Mycoses and AIDS

Giemsa and Grocott in the recognition of Histoplasma capsulatum in blood smears

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Asian Pacific Journal of Tropical Biomedicine 2013年第5期3卷 418-420页

作者： Javier Bava Alcides Troncoso Laboratory of Parasitology Infectious Diseases Muniz Hospital Department of Microbiology and Infectious Diseases School of MedicineUniversity of Buenos Aires

Objective:To facilitate the recognition of intracellular yeasts of Histoplasma capsulation and differentiate it from Leishmania amastigotes and other parasites,using the combination of Giemsa and a rapid modification of Grocott stains to peripheral blood smears in a hematological ***:The combination of both stains was applied consecutively(first Grocott and then Giemsa)to previously fixed peripheral blood *** was performed with 400x and 1000x,the latter using immersion ***:The yeasts of Histoplasma capsulatum were observed into the cytoplasm of leukocytes as brownish oval elements,with 3-4μm in ***:The combination of both techniques is a simple and fast method to facilitate recognition of intracellular yeasts and it is different from intracellular parasitic ***,it allows distinguishing the cell elements that are in the microscopic *** may be very helpful in those cases in which the presumptive diagnosis of histoplasmosis has not been established yet and where other more sophisticated methods are not available.

关键词： histoplasmosis Peripheral blood smear Visceral leishmaniasis HIV