Pulmonary histoplasmosis in an immunocompetent patient without history of travel in endemic areas

Publication date: Available online 6 November 2019Source: Respiratory Medicine Case ReportsAuthor(s): Serao Mattia, Marianna Lilli, Angela Succu, Tiziana Trequattrini, Rossana Vigliarolo, Giuseppina Gioffrè, Rosario Rivitti, Aldo Ciani, Shakib Zyada, Silvia Candia, Maria Cristina ZappaAbstractHistoplasma capsulatum is a dimorphic fungus, non-endemic in Italy but endemic in America, Asia and tropical Africa. People who generally visit an endemic area may aspirate spores and run the risk of infection. The aerosolization of micronids or hyphal fragments is considered to cause the epidemic. In most people this fungus, which is not able to cause extensive disease, generates self-limiting infections which are limited by the action of mediated cell immunityThe self-limiting form of histoplasmosis is characterized by a flu-syndrome with fever, cough, chest pain, headache, myalgia and atralgia with bilateral lung hilar adenopathies. It resolves with supportive therapy and may not require specific therapy.If not treated, however, in one case out of 100,000 it proceeds to a pulmonary and extrapulmonary disseminated form with hepatosplenomegaly and pancytopenia by marrow infiltration. Acute histoplasmosis disseminated in the immunodepressed patient may cause septic shock with pulmonary ARDS and death within a few days, if left untreated.
Source: Respiratory Medicine Case Reports - Category: Respiratory Medicine Source Type: research

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