Abstract
ABSTRACTHistoplasmosis is an infection caused by the dimorphic fungus Histoplasma capsulatum. The disease is endemic in several regions of tropical and temperate climate. The fungus presents opportunistic behavior, causing widespread infection in immunocompromised patients, resulting from complication of primary pulmonary infection, due to exogenous reinfection or reactivation of a quiescent source. In immunocompetent individuals, approximately 95% of pulmonary infections are asymptomatic. However, prolonged exposure to high amount spores may lead to acute or chronic lung infection. Due to the low amount of inoculum, primary cutaneous histoplasmosis caused by traumatic implantation is extremely rare and effectively treated with triazoles. Thus, the present study aims to report a case of primary cutaneous histoplasmosis that is difficult to treat in an immunocompetent patient, and to review the literature on the incidence of drug-resistant Histoplasma capsulatum strains in clinical practice.
Highlights
The etiologic agent of histoplasmosis, Histoplasma capsulatum, is a dimorphic fungus found in the form of filamentous mycelium, with micro and macroconidia, einstein (São Paulo). 2021;19:1-4Batista JM, Martins MA, Bertollo CM in soil contaminated by bird and bat feces.(1) The disease is endemic in tropical and temperate climate regions, such as in the river valleys of North and Central America, South America, eastern and southern Europe, eastern Asia, Africa, and Australia
The present study aims to report a case of primary cutaneous histoplasmosis that is difficult to treat in an immunocompetent patient, and to review the literature on the incidence of drug-resistant Histoplasma capsulatum strains in clinical practice
Primary cutaneous histoplasmosis difficult to treat in immunocompetent patient: case report and literature review. einstein (São Paulo). 2021;19:eRC5488
Summary
Primary cutaneous histoplasmosis difficult to treat in immunocompetent patient: case report and literature review. The present study aims to report a case of primary cutaneous histoplasmosis that is difficult to treat in an immunocompetent patient, and to review the literature on the incidence of drug-resistant Histoplasma capsulatum strains in clinical practice. Due to the low amount of inoculum, the occurrence of primary cutaneous histoplasmosis (PCH) by traumatic implantation, is extremely rare in nonimmunocompromised patients and is effectively treated with triazoles.(1) the aim of the present study is to report a case of difficult-to-treat PCH case in an immunocompetent patient with no history of previous exposure to risky environments, such as caves and poultry facilities, and to review the literature on the incidence of H. capsulatum strains resistant to drugs used in clinical practice. The fungi showed remarkably regular morphology, presenting as small, well-defined, slightly oval yeasts, approximately 2mm to 4mm in size, forming rows
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