Nandí-Lozano E, Newton-Sánchez O, Ávila-Figueroa C

Language: Spanish
References: 33
Page: 47-54
PDF size: 118.60 Kb.

ABSTRACT

Introduction. Histoplasmosis is one of the most prevalent systemic mycosis in humans. Those younger than 2 years of age, and individuals whose immune systems are compromised, are more likely to develop symptoms.
Case reports. All 5 cases were female. The ages of the patients varied from 30 months to 16 years. Concomitant diseases included HIV infection (3) and lupus erythematosus (1). Clinical symptoms were: fever, cough, respiratory distress and hepatosplenomegaly. All had hematologic disorders, anemia, decreased leukocytes count and decreased platelets. Chest roentgenogram showed multiples infiltrates. All the patients received amphotericin B, and all of them died. The clinical specimens that showed Histoplasma capsulatum were bone marrow biopsy and bronchoalveolar lavage.
Conclusions. Systemic histoplasmosis was associated with patients with deteriorated immunologic system. The patients had clinical evidence of infection, respiratory symptoms and pulmonary infiltrates. In immunocompromised patients with signs and symptoms suggestive of histoplasmosis, empiric antifungal therapy is warranted.

REFERENCES

1. Salazar HAC, Martínez PG, Dehesa TR. Histoplasmosis diseminada. Bol Med Hosp Infant Mex. 1998; 55: 399-402.

2. Hughes WT. Hematogenous histoplasmosis in the immunocompromised child. J Pediatr. 1984; 105: 569-75.

3. González ZI, Vargas YR, Velasco CO, Taylor ML. Histoplasmosis. Rev Fac Med UNAM. 1998; 41: 12-5.

4. Kaplan JE, Roselle G, Sepkowitz K. Opportunistic infections in immunodeficient populations. Emerg Infect Dis. 1998; 4: 421-2.

5. Schutze GE, Tucker NC, Jacobs RF. Histoplasmosis and perinatal human immunodeficiency virus. Pediatr Infect Dis J. 1992; 11: 501.

6. Wheat LJ. Histoplasmosis in Indianapolis. Clin Infect Dis J. 1992; 14 Supl 1: S91-9.

7. Leggiadro RJ, Barett FF, Hughes WT. Disseminated histoplasmosis of infancy. Pediatr Infect Dis J. 1988; 7: 799-805.

8. Ramón GG, Peña AR, Ontiveros NP. Histoplasmosis diseminada en niños. Bol Med Hosp Infant Mex. 1993; 50: 870-5.

9. Deepe G. Histoplasma capsulatum. En: Mandell GL, Bennet JE, editores. Principles and practice of infectious diseases. 5th ed. Philadelphia: Churchill Livingstone; 2000. p. 2718-33.

10. Quasney MW, Leggiadro RJ. Pleural effusion associated with histoplasmosis. Pediatr Infect Dis J. 1993; 12: 415-8.

11. Wheat LJ. Current diagnosis of histoplasmosis. Trends Microbiol. 2003; 11: 488-94.

12. Zúñiga RJ, Hernández MB, Rodríguez RT, Granados J. Inmunogenética de la histoplasmosis. Rev Inst Nal Enf Respir Mex. 1998; 11: 226-8.

13. Vázquez TO, Campos RT, Martínez BI. Histoplasmosis. Abordaje terapéutico. Acta Pediatr Mex. 2004; 25: 349-53.

14. Vaca MMA, Martínez RMA, Flores EJJ. Histoplasmosis en México, aspectos históricos y epidemiológicos. Rev Inst Nal Enf Respir Mex. 1998; 11: 208-15.

15. Taylor ML, Morales QA, Chávez CCR, García TD, Montaño OG, Pedroza SM. Actualidades inmunológicas y moleculares sobre la epidemiología de la histoplasmosis en Morelos, México. Gac Med Mex. 2000; 135: 441-8.

16. Weinberg M, Weeks J, Lance PS, Traeger M, Wiersma S, Phan Q, et al. Severe histoplasmosis in travellers to Nicaragua. Emerg Infect Dis. 2003; 9: 1322-5.

17. Diamond RD. The growing problem of mycoses in patients infected with the human immunodeficiency virus. Rev Infect Dis. 1991; 13: 480-6.

18. Mateo BT, Peña AR, Cashat CM, Santos PJI. Histoplasmosis diseminada en niños inmunocomprometidos. Bol Med Hosp Infant Mex. 1996; 53: 623-7.

19. Orozco TR, Reyes E. Histoplasmosis cutánea en nueve pacientes con SIDA. Rev Inv Clin. 1998; 50: 525-8.

20. LeMonte AM, Washum KE, Smedema ML, Schnizlein-Bick C, Kohler SM, Wheat LJ. Amphotericin B combined with itraconazole or fluconazole for treatment of histoplasmosis. J Infect Dis. 2000; 182: 545-50.

21. Casanova CLJ, Ruiz OI. Histoplasma capsulatum en sangre periférica de pacientes con SIDA. Informe de cuatro casos con elevación de deshidrogenasa láctica. Rev Invest Clin. 1993; 45: 67-70.

22. Levi GC, Pozzi CM, Hirschheimer SMDS, Chahade WH, Gomes HR, Granato C. Histoplasmose do sistema nervosa central como unica manifestaçao da doença em pacientes imunocompetentes. Arq Neuropsiquiatr. 2003; 61: 859-63.

23. Cohen M, Sahn SA. Resolution of pleural effusions. Chest. 2001; 119: 1547-62.

24. Hodgson N, Inculet R. Acute airway obstruction secondary to bilateral broncholithiasis. Chest. 2000; 117: 1205-7.

25. Carrada BT. Histoplasmosis diseminada en dos pacientes infectados con el VIH. Med Int Mex. 2005; 21: 84-9.

26. De José GMI, Orio HM, Bilbao GA, García RJ, Baquero AF. Histoplasmosis diseminada. Ann Pediatr. 2005; 63: 249-52.

27. Reyes M, Arenas LR, Pichardo P, Vick R, Torres A, Zacarías R. Histoplasmosis cutánea y SIDA. Gac Med Mex. 2003; 139: 270-5.

28. Tobon AM, Agudelo CA, Rosero DS, Ochoa JE, de Bedout C, Zuluaga A, et al. Disseminated histoplasmosis: a comparative study between patients with acquired immunodeficiency syndrome and non-human immunodeficiency virus-infected individuals. Am J Trop Med Hyg. 2005; 73: 576-82.

29. Sullivan AA, Benson SM, Ewart AH, Hogan PG, Whitby RM, Boyle RS. Cerebral histoplasmosis in an Australian patient with systemic lupus erythematosus. Med J Aust. 1998; 169: 201-2.

30. McKinsey DS, Kauffman CA, Pappas PG. Fluconazole therapy for histoplasmosis. Clin Infect Dis. 1996; 23: 996-1001.

31. Durkin M, Kohler S, Schnizlein-Bick C, LeMonte A, Connolly P, Goldberg J, et al. Chronic infection and reactivation in a pulmonary challenge model of histoplasmosis. J Infect Dis. 2001; 183: 1822-4.

32. Wheat LJ. Histoplasmosis: recognition and treatment. Clin Infect Dis. 1994; 19 Supl 1: 519-27.

33. Fosson AR, Wheeler WE. Short-term amphotericin B treatment of severe childhood histoplasmosis. J Pediatr. 1975; 86: 32-6.