Abstract
Histoplasmosis is a dimorphic fungal infection caused by histoplasma capsulatum . It is the most prevalent endemic mycosis in the United States, but now it is a disease of world wide occurrence. Most infections are asymptomatic or self-limited, some individuals develop acute pulmonary infections or severe and progressive disseminated infection. Progressive disseminated histoplasmosis occurs in about one in 2000 patients with acute infection. Besides lung it may affect skin, lymph nodes, GIT, CNS, adrenals, liver and spleen. The patient of disseminated histoplasmosis usually presents with fever, anorexia, weight loss, myalgia and manifestations according to organ involved. Here we described a 45 year-male who presented to us with fever, weight loss, generalized lymphadenopathy, growths in the oral cavity and chylous ascites. The particular interest of this paper is to present a case of disseminated histoplasmosis in an immunocompetent host without pulmonary involvement, and to demonstrate the differences between this entity and other similarly presented diseases like disseminated tuberculosis, lymphoma and metastatic malignancy. Key words: histoplasmosis; disseminated histoplasmosis; histoplasma capsulatum; immunocompetent host; Bangladesh. DOI: 10.3329/bsmmuj.v3i1.5515 BSMMU J 2010; 3(1): 44-46
Highlights
Histoplasmosis is the most common endemic mycosis in human. It has recently emerged as an important opportunistic infection among human immunodeficiency virus (HIV)-infected persons living in areas where it is endemic[1]
Severe disseminated histoplasmosis develops in people with primary or secondary deficiency of cellular immunity
We report our experience to increase awareness of the clinical spectrum of disseminated histoplasmosis and its similarity to other infections and malignancies and update the reader on recommended therapeutic modalities
Summary
Histoplasmosis is the most common endemic mycosis in human. It has recently emerged as an important opportunistic infection among human immunodeficiency virus (HIV)-infected persons living in areas where it is endemic[1].Histoplasma capsulatum is a dimorphic fungus that remains in a mycelial form at ambient temperatures and grows as yeast at body temperature and transmitted by inhalation of the spores. Severe disseminated histoplasmosis develops in people with primary or secondary deficiency of cellular immunity. Its presentation varies depending on the size of the inoculum, host’s immune status, and presence of underlying lung disease. 10% cases of histoplasmosis develop into progressive disseminated histoplasmosis (PDH).[2]
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