Abstract
Objective: To determine the prevalence of nasal septum perforation associated to Histoplasma sp. Material and Methods: A retrospective descriptive study was conducted with patients who developed nasal septum perforation associated to histoplasmosis. The diagnosis was made based on clinical manifestations and confirmed with mycological direct examination with Giemsa stain, culture, serologic tests (immunodiffusion method), and histopathology with hematoxylin-eosin, Grocott methenamine (GMS) and Periodic Acid-Schiff stain (PAS). Results: Out of 1654 medical records reviewed with diagnosis of histoplasmosis in the study period, we found 22 cases with nasal septum perforation. Autoimmune disease was present in 6 patients; all six were on immunosuppressive treatment. Two patients had HIV/AIDS, one of them had also paracoccidiodomycoses and the remaining had no apparent underlying disease or conditions . Conclusion: Physicians of endemic areas such as Venezuela, must consider this entity in the differential diagnosis with other diseases.
Highlights
Histoplasmosis is a granulomatous disease with worldwide distribution caused by Histoplasma spp
Most patients resided in urban areas (68.2%), with most cases coming from the north-central endemic region of Venezuela
The rest of the patients came from other endemic areas of the country
Summary
Histoplasmosis is a granulomatous disease with worldwide distribution caused by Histoplasma spp. It has been described in every continent except Antarctica; frequently, it has been reported in the United States, Mexico, Central and South America. In Venezuela, this mycosis is the main fungal infection causing hospitalization and maybe death [1,2,3]. The global burden of histoplasmosis has been increasing, as a result of climate change, progression of HIV/AIDS, increasing number of patients with malignancies, organ transplant surgery, immunological conditions receiving immunosuppressive treatment, patients at the extremes of age as well as the detriment in the population’s socioeconomic conditions (malnutrition among others) [4,5]. The dormant organisms pose little risk unless the patient becomes immunosuppressed as a result of the aforementioned risk factors [4,6]
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