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Campbell AP, Qiu L, Dillman JR, Trout AT, Szabo S, Lopez-Nunez OF, Pugmire BS, Schapiro AH. Endemic mycoses in children in North America: a review of radiologic findings. Pediatr Radiol 2023; 53:984-1004. [PMID: 36922418 PMCID: PMC10017348 DOI: 10.1007/s00247-023-05636-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 02/17/2023] [Accepted: 02/17/2023] [Indexed: 03/18/2023]
Abstract
Clinically significant endemic mycoses (fungal infections) in the United States (U.S.) include Blastomyces dermatitidis, Histoplasma capsulatum, and Coccidioides immitis/posadasii. While the majority of infections go clinically unnoticed, symptomatic disease can occur in immunocompromised or hospitalized patients, and occasionally in immune-competent individuals. Clinical manifestations vary widely and their diagnosis may require fungal culture, making the rapid diagnosis a challenge. Imaging can be helpful in making a clinical diagnosis prior to laboratory confirmation, as well as assist in characterizing disease extent and severity. In this review, we discuss the three major endemic fungal infections that occur in the U.S., including mycology, epidemiology, clinical presentations, and typical imaging features with an emphasis on the pediatric population.
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Affiliation(s)
- Abraham P Campbell
- Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Lisa Qiu
- Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
| | - Jonathan R Dillman
- Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Andrew T Trout
- Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sara Szabo
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Oscar F Lopez-Nunez
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Brian S Pugmire
- Department of Radiology, Rady Children's Hospital San Diego, San Diego, CA, USA
| | - Andrew H Schapiro
- Department of Radiology, MLC 5031, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA.
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
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Herber M, Kaeuffer C, Martin A, Averous G, Nguimpi-Tambou M, Klipfel A, Hansmann Y, Lefebvre N, Argemi X, Ruch Y, Prendki V. [Persistent diarrhea in a 77 year-old woman]. Rev Med Interne 2019; 41:134-137. [PMID: 31421900 DOI: 10.1016/j.revmed.2019.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 07/04/2019] [Indexed: 11/18/2022]
Affiliation(s)
- M Herber
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France.
| | - C Kaeuffer
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - A Martin
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - G Averous
- Service d'anatomie pathologique, CHU de Strasbourg, hôpital de Haute-Pierre, 1, avenue Molière, Strasbourg 67200, France
| | - M Nguimpi-Tambou
- Service d'hépato-gastro-entérologie, CHU de Strasbourg, Haute-Pierre, 1, avenue Molière, Strasbourg cedex 67091, France
| | - A Klipfel
- Service de chirurgie digestive, CHU de Strasbourg, Haute-Pierre, 1, avenue Molière, Strasbourg cedex 67091, France
| | - Y Hansmann
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - N Lefebvre
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - X Argemi
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - Y Ruch
- Service de maladies infectieuses et tropicales, CHU de Strasbourg, Nouvel hôpital civil, 1, place de l'Hôpital, 67091 Strasbourg cedex, France
| | - V Prendki
- Service de médecine Interne de l'Agé, hôpitaux universitaires de Genève, faculté de médecine de Genève, Suisse
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Abstract
Histoplasmosis is an infection caused by a fungus called Histoplasma. Diagnosis of histoplasmosis is based on the culture of biological samples and detection of fungus in tissues. Histoplasmosis can mimic malignant lesions. We report a 65-year-old, immunocompetent, male patient with back pain. We describe the main clinical and radiological characteristics in our patient who had vertebral histoplasmosis that mimicked cancer. A computed tomography scan showed lytic lesions of the right side of T4, T5, and T6 vertebral bodies. Magnetic resonance imaging displayed abnormal marrow signals in T4, T5, and T6 vertebral bodies (low signal on T1, high on T2 and short time inversion recovery (STIR)). Which was mimicking malignancy, such as haematological malignancy and metastatic bone cancer. Therefore, thoracic spinal surgery using the anterior approach was performed. An intraoperative frozen section examination and routine postoperative pathology showed thoracic histoplasmosis infection. Treatment of histoplasmosis was performed with oral itraconazole. The lesions did not progress and the patient symptomatically improved at a follow-up of 26 months.
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Affiliation(s)
- Bing Liu
- 1 Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Liyan Qu
- 2 Clinical Laboratory Centre, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.,3 Clinical Laboratory Centre, Binjiang Hospital of Hangzhou, Hangzhou, Zhejiang, China
| | - Jian Zhu
- 1 Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhengming Yang
- 1 Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Shigui Yan
- 1 Department of Orthopedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Rimtepathip PP, Erickson A, Katner H, Bakri Y. Disseminated histoplasmosis presenting as pelvic inflammatory disease. Clin Case Rep 2016; 4:76-80. [PMID: 26783441 PMCID: PMC4706388 DOI: 10.1002/ccr3.456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 09/24/2015] [Accepted: 10/28/2015] [Indexed: 11/23/2022] Open
Abstract
A 39‐year‐old female patient was presented with acute abdominal pain. Diagnostic laparoscopy revealed extensive granulomas throughout the abdomen. Disseminated TB was suspected, but the biopsies were negative. Due to a high degree of suspicion, a urine antigen test was performed and was strongly positive for histoplasmosis.
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Affiliation(s)
| | - Alex Erickson
- Mercer University School of Medicine Macon Georgia USA
| | - Harold Katner
- Department of Infectious Disease Mercer University School of Medicine Macon Georgia USA
| | - Younes Bakri
- Gynecological oncology and Obstetrics and Gynecology Mercer University School of Medicine Macon Georgia USA
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