MyMedR

Disseminated histoplasmosis presenting as penile ulcer

Jayalakshmi P, Goh KL, Soo-Hoo TS, Daud A

Aust N Z J Med, 1990 Apr;20(2):175-6.

A 59-year-old Chinese man presented with a three month history of penile ulcers and abdominal pain. Syphilis and a gastric malignancy were diagnosed clinically. Biopsy of the genital and stomach ulcers revealed histiocytic granulomata containing numerous intracellular fungal bodies. Histoplasma capsulatum was subsequently cultured from the penile ulcer. Antifungal therapy was instituted. However the patient's general condition deteriorated rapidly and he died within two weeks of admission. A post-mortem liver biopsy showed numerous intracellular fungi.

Matched MeSH terms: Histoplasmosis/diagnosis*

Primary mucocutaneous histoplasmosis

Dutt AK, Garai BK

Med J Malaya, 1970 Mar;24(3):231-3.

PMID: 4246808

Matched MeSH terms: Histoplasmosis/diagnosis*

Fulltext Disseminated histoplasmosis presenting with chronic ulcerative tongue lesions in a patient with diabetes

Hasmoni MH, Shah AS, Ayoub S, Hin LS, Abd Rashid MA

BMJ Case Rep, 2010;2010.

PMID: 22791841 DOI: 10.1136/bcr.06.2010.3120

Matched MeSH terms: Histoplasmosis/diagnosis*

Histoplasmosis presenting with progressively worsening backache--a case report

Lachmanan SR, Haniza O, Hisham AN, Subramaniam J, Merican I

Ann Acad Med Singap, 2001 Nov;30(6):656-8.

PMID: 11817299

INTRODUCTION: Bilateral adrenal enlargement is often the result of disseminated malignant disease, and this diagnosis is particularly likely in a patient with severe weight loss. We describe a case with bilateral adrenal enlargement presenting with progressively worsening backache as a prominent symptom.

CLINICAL PICTURE: A 55-year-old man presented with intermittent low back pain which was progressively worsening, fever, anorexia, low back pain and a 10-kg weight loss. He had underlying diabetes mellitus and ischaemic heart disease. He gave a history of travel to caves for worship. Clinically, the most significant findings included nodular lesions in the anterior fauces and left palatoglossal region. Computed tomographic scan revealed bilateral adrenal masses. Biopsies were taken from the palatal nodules, which revealed histiocytes with numerous histoplasma organisms.

TREATMENT: He was commenced on itraconazole 200 mg daily for a period of 9 months. There was a dramatic initial response with settling of his fever and this was followed by subjective improvement in his well-being.

OUTCOME: He is presently on follow-up and has completed 9 months of itraconazole therapy with resolution of all his symptoms and has gained about 10 kg of weight.

Matched MeSH terms: Histoplasmosis/diagnosis

Disseminated histoplasmosis presenting with ileal perforation in a renal transplant recipient

Zainudin BM, Kassim F, Annuar NM, Lim CS, Ghazali AK, Murad Z

J Trop Med Hyg, 1992 Aug;95(4):276-9.

PMID: 1495124

A renal transplant patient presented with ileal perforation due to histoplasmosis 3 years after transplantation. Mesenteric lymph nodes and lungs were also affected by the disease. She was successfully treated with amphotericin B followed by ketoconazole.

Matched MeSH terms: Histoplasmosis/diagnosis*

Fulltext Disseminated histoplasmosis presenting as a non-healing tongue ulcer

Liam CK, Chua CT, Pathmanathan R

Singapore Med J, 1990 Jun;31(3):286-8.

PMID: 2392708

A 51-year old man presented with a persistent tongue ulcer, fever, cervical lymphadenopathy and hepatomegaly. The diagnosis was initially thought to be tuberculosis. This led to the initiation of antituberculous chemotherapy to which the patient failed to respond. The correct diagnosis of histoplasmosis was made after the detection of Histoplasma capsulatum on further review of the tongue ulcer biopsy specimen. He responded to treatment with amphotericin B.

Matched MeSH terms: Histoplasmosis/diagnosis*

Sensitivity to tuberculin, PPD-B and histoplasmin in the population of Sabah in East Malaysia

Roy RN

Med J Aust, 1971 Feb 06;1(6):317-21.

PMID: 5546216

Matched MeSH terms: Histoplasmosis/diagnosis

Oral histoplasmosis presenting as oral ulcer in a non-HIV patient

Rahman MT, Bakar NH, Philip R, Shamsudin AR

Southeast Asian J Trop Med Public Health, 2004 Jun;35(2):388-90.

PMID: 15691142

A 40-year-old man presented with chronic mouth ulcer for the last six months. Histopathological examination of the biopsy from the lesion confirmed a diagnosis of histoplasmosis. Although histoplasmosis commonly manifests in immunocompromized patients, like HIV, the present case was negative for HIV. Histoplasmosis is endemic in certain parts of the world and it is comparatively rare in the South Asian region, particularly Malaysia. Thirty-seven cases of histoplasmosis were reported from Malaysia (Ng and Siar, 1996), between July 1967 and October 1997. Despite the apparent rarity of the disease, clinicians and pathologists should be aware of the possibility of histoplasmosis when cases of oral ulcer are encountered.

Matched MeSH terms: Histoplasmosis/diagnosis*

Fulltext Bilateral adrenal histoplasmosis: endoscopic ultrasound-guided fine needle aspiration as a method of diagnosis and assessment

Khairul Azhar J, Jacqueline HSG, Tony LKH, Tan BH, Steven JM

Med J Malaysia, 2011 Dec;66(5):504-6.

PMID: 22390113

We report a case of a healthy 78-year-old indonesian man who presented with chronic weight loss, poor appetite and lethargy. CT abdomen showed bilateral adrenal masses. EUS-guided FNA was performed on the left adrenal gland. Histopathology report was Histoplasma Capsulatum. He recovered well with antifungal treatment without any complication. In this case, we found that the role of EUS -guided FNA was not only limited to diagnosis but also helped in the prognosis of the disease since the method was able to assess the general anatomy of the adrenal gland better than other imaging modalities due to its close proximity and direct visualization.

Matched MeSH terms: Histoplasmosis/diagnosis*

An outbreak of histoplasmosis among healthy young Japanese women after traveling to Southeast Asia

Ohno H, Ogata Y, Suguro H, Yokota S, Watanabe A, Kamei K, et al.

Intern. Med., 2010;49(5):491-5.

PMID: 20190491

Histoplasmosis, caused by Histoplasma capsulatum, is an endemic mycosis in many countries of the world except for Japan. Outbreaks of histoplasmosis among Japanese people are very rare and are mainly imported by travelers. We report an outbreak of histoplasmosis among healthy Japanese people who traveled to a resort area in Southeast Asia. Three young Japanese women traveled to Langkawi island, Malaysia and stayed on the island for five days without visiting caves, a known reservoir of H. capsulatum. All three individuals developed flu-like symptoms with multiple nodule shadows on chest X rays or chest CT scans at around ten days after their return to Japan. Serum samples obtained from the three subjects were positive for anti-Histoplasma antibody and specific PCR for H. capsulatum on lung biopsy specimens and the serum from one patient was positive. The clinical course of all three patients improved without the use of anti-fungal agents and no recurrence has been confirmed. Clinical attendants should consider histoplasmosis when they see patients with flu-like symptoms with abnormal chest X-rays after visiting H. capsulatum endemic areas, especially Southeast Asia.

Matched MeSH terms: Histoplasmosis/diagnosis*

Occurrence of histoplasmosis in Asia

Randhawa HS

Mycopathol Mycol Appl, 1970;41(1):75-89.

PMID: 4938836

Matched MeSH terms: Histoplasmosis/diagnosis

Fulltext Laryngeal histoplasmosis: an occupational hazard

Teoh JW, Hassan F, Mohamad Yunus MR

Singapore Med J, 2013 Oct;54(10):e208-10.

PMID: 24154590

Isolated laryngeal histoplasmosis is a very rare entity. It has variable clinical presentations that might mimic both benign and malignant lesions, and is usually associated with pulmonary and other disseminated forms of histoplasmosis. Herein, we report a case of primary laryngeal histoplasmosis without the involvement of other systems in a 70-year-old Chinese man, who previously worked as a miner. He presented with a history of hoarseness for two months, with no other associated symptoms. Direct laryngoscopy revealed irregularity of the posterior one-third of both vocal folds. Histopathological examination revealed the presence of Histoplasma capsulatumon periodic acidSchiff and Grocott's methenamine silver staining. The lesion resolved after one month of oral itraconazole treatment. However, the patient had to complete six months of antifungal treatment to prevent recurrence.

Matched MeSH terms: Histoplasmosis/diagnosis

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