Primary Cutaneous Histoplasmosis Research Articles

Histoplasmosis during childhood.

To define the clinical presentation of histoplasmosis among hospitalized children, we reviewed the charts of patients treated for histoplasmosis at Vanderbilt University Children's Hospital during the years 1968 through 1988. Thirty-five patients with histoplasmosis diagnosed by culture, pathologic examination, or serologic testing were identified, including 29 patients (83%) with pulmonary/mediastinal infection, 5 (14%) with disseminated disease, and 1 (3%) with primary cutaneous histoplasmosis. The most common symptoms included fever, present in 26 patients (74%), and cough, present in 20 (57%). Of 26 patients with fever, 18 (69%) had fever of > 2 weeks' duration and 7 (27%) had temperatures > or = 40.5 degrees C (> or = 105 degrees F). Abnormal physical findings were few, but 19 patients (54%) had wheezing. Chest radiographs were obtained in all cases except one; 31 (91%) showed abnormalities, including adenopathy in 25 cases (74%) and infiltrates in 19 (56%). Histoplasmin skin tests were positive for 22 (96%) of the 23 patients tested. No cases of classic disseminated histoplasmosis of infancy were identified. Histoplasmosis should be considered in the differential diagnosis when children living in endemic areas are evaluated for persistent fever, cough, and/or wheezing, particularly if adenopathy is seen on the chest radiograph.

Primary Cutaneous Histoplasmosis in Immunosuppressed Patient

<i>HISTOPLASMA CAPSULATUM</i>may cause several types of cutaneous manifestations. Disseminated histoplasmosis has been most commonly associated with oral mucocutaneous ulcers,^1-3which may persist longer than three months. The progressive cutaneous form of disseminated histoplasmosis may appear as granulomas, ulcerations, or papulonecrotic lesions. Differentiation of these lesions from other cutaneous ulcers on clinical grounds alone is difficult if not impossible. Etiologic confirmation is determined by isolating<i>H capsulatum</i>, usually from a biopsy specimen. Primary cutaneous histoplasmosis, in which the organism is confined to the skin, is uncommon. To our knowledge, only three verified cases have been reported.^4-6Furcolow⁷has reviewed previous possible cases. In each of the three verified cases, the infection was self-limited without systemic therapy. The purpose of this report is to present a fourth case of apparent primary cutaneous histoplasmosis. The disease in this immunosuppressed patient differed from previously reported cases of primary cutaneous histoplasmosis in being

Primary cutaneous histoplasmosis in immunosuppressed patient

Primary cutaneous histoplasmosis in immunosuppressed patient

Isolated Nodular Cutaneous Histoplasmosis

• Cutaneous manifestations of histoplasmosis may be divided into primary and secondary lesions. Primary cutaneous histoplasmosis is rare; to our knowledge, there are only three reported cases in the literature. Secondary cutaneous histoplasmosis develops during the course of disseminated disease. An isolated nodule of the hand was the initially appearing sign of recurrent disseminated disease in our patient. Because of the extreme rarity of primary cutaneous histoplasmosis, cutaneous lesions that are proven to be due to histoplasmosis should alert the physician to the presence of disseminated disease. (<i>Arch Dermatol</i>114:1197-1198, 1978)

EXPERIMENTAL CUTANEOUS HISTOPLASMOSIS IN HAMSTERS.

After subcutaneous injection of Histoplasma capsulatum into hamsters, a primary complex (cutaneous lesion plus involvement of regional lymphnodes) developed with regularity. The ensuing hematogenous spread was governed primarily by the invasiveness of the individual strains. Primary cutaneous histoplasmosis provided only partial protection to challenge with the same organism. Human cutaneous infections with fungi are acceptable as primary only if a chancre with regional lymphnodes is demonstrated in conjunction with traumatic inoculation.

PRIMARY CUTANEOUS HISTOPLASMOSIS. REPORT OF A CASE.

Histoplasmosis was considered a rare and always fatal disease for many years after it was first described by Darling in 1906. However, recent epidemiological studies in the United States have revealed that in some states in the endemic area 60% to 70% of males aged 17 through 21 years have been infected with<i>Histoplasma capsulatum</i>.¹The respiratory tract is the usual portal of entry of the fungus with the primary lesion occurring in the lungs.²Cases of histoplasmosis having skin lesions have been reported, but the skin lesions were usually the result of dissemination of the infection.^3,4The purpose of this paper is to report a case of primary cutaneous histoplasmosis which resulted from direct inoculation of the fungus through the skin. <h3>Report of Case</h3> On Jan 12, 1959, a 32-year-old white male who had recently moved into the endemic area for histoplasmosis assisted with an autopsy