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Hirayama T, Takazono T, Iwata K, Senju H, Shimazaki T, Tashiro M, Saijo T, Tanaka T, Nakamura S, Imamura Y, Kojiro M, Miyazaki T, Tsukamoto M, Furumoto A, Morimoto K, Muraosa Y, Matsubara Y, Yanagihara K, Mukae H, Kamei K, Kohno S, Izumikawa K. A case series of histoplasmosis patients with elevated serum soluble interleukin-2 receptor levels. J Infect Chemother 2017; 23:642-647. [PMID: 28395939 DOI: 10.1016/j.jiac.2017.03.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/01/2017] [Accepted: 03/10/2017] [Indexed: 10/19/2022]
Abstract
Histoplasmosis is a common endemic mycosis that is usually asymptomatic but occasionally results in severe illness. Histoplasmosis and its causative agent, Histoplasma capsulatum, are found worldwide but rarely in Japan. In recent years, however, the number of histoplasmosis patients in Japan has increased. In addition, to our knowledge, there are no previous reports of increased serum soluble interleukin-2 receptor (sIL-2R) levels in patients with histoplasmosis. We report a case series of histoplasmosis in three Japanese temporary workers in Manzanillo, Mexico. All three patients developed a persistent high fever and general fatigue. Laboratory tests showed increased C-reactive protein levels and mild liver dysfunction. All patients also showed increased soluble interleukin-2 receptor (sIL-2R) levels. Chest computed tomography revealed multiple nodules in both lung fields. All patients were positive for serum anti-Histoplasma antibodies, and two patients were positive for Histoplasma on polymerase chain reaction tests. After treatment that included antifungals, their conditions gradually improved and laboratory data normalized. Although one patient developed respiratory failure, this patient recovered with antifungal therapy in combination with methylprednisolone. Serum sIL-2R levels in all patients gradually declined to normal levels, indicating their recovery from Histoplasma infection. From our experience with these patients, sIL-2R levels may be a useful biomarker for patients with histoplasmosis.
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Affiliation(s)
- Tatsuro Hirayama
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takahiro Takazono
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Kazuma Iwata
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki, Japan; Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Hiroaki Senju
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takaharu Shimazaki
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki, Japan; Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Masato Tashiro
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Tomomi Saijo
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takeshi Tanaka
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki, Japan; Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Shigeki Nakamura
- Department of Chemotherapy and Mycoses, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshifumi Imamura
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Maiko Kojiro
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki, Japan; Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Taiga Miyazaki
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Misuzu Tsukamoto
- Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
| | - Akitsugu Furumoto
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki, Japan; Division of Infectious Diseases Department of Internal Medicine Nagasaki Rosai Hospital, Nagasaki, Japan
| | - Konosuke Morimoto
- Department of Infectious Diseases, Nagasaki University Hospital, Nagasaki, Japan; Department of Clinical Medicine, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - Yasunori Muraosa
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | | | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Hiroshi Mukae
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan; Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Katsuhiko Kamei
- Medical Mycology Research Center, Chiba University, Chiba, Japan
| | - Shigeru Kohno
- Second Department of Internal Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan; Infection Control and Education Center, Nagasaki University Hospital, Nagasaki, Japan
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