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Bagga N, Sharma K, Tuteja RK, Sharma S, Negi SR, Mathur SL. Disseminated Histoplasmosis detected on peripheral blood smear examination in immunocompetent patients from non endemic region - Report of two cases from a tertiary care hospital. INDIAN J PATHOL MICR 2021; 63:645-647. [PMID: 33154327 DOI: 10.4103/ijpm.ijpm_898_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Histoplasmosis is an opportunistic systemic infection caused by inhaling spores of a thermal dimorphic fungus Histoplasma capsulatum. Disseminated histoplasmosis is the most common form associated with acquired immune deficiency syndrome (AIDS). However, only a few cases of disseminated histoplasmosis are reported in immuno-competent hosts. Most infections in the immunocompetent hosts are asymptomatic or result in mild pulmonary disease. However the presence of Disseminated Histoplasmosis in immunocompetent host probably results due to prolonged exposure and delayed presentation We report two cases of progressive disseminated histoplasmosis in two immunocompetent patients from non-endemic region in Western Rajasthan, India. Also in both the cases, the first diagnosis was suggested by a peripheral blood smear, which is not a classical biological diagnostic method for fungal infection. Careful examination of Peripheral blood smear along with correct clinical history can aid in early diagnosis of disseminated histoplasmosis even in immunocompetent patients.
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Affiliation(s)
- Neha Bagga
- Department of Pathology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
| | - Kamna Sharma
- Department of Botany, Jai Narain Vyas University, Jodhpur, Rajasthan, India
| | - Rajat K Tuteja
- Department of Internal Medicine, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
| | - Satyaprakash Sharma
- Department of Pathology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
| | - S R Negi
- Department of Pathology, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
| | - S L Mathur
- Department of Internal Medicine, Dr. S. N. Medical College, Jodhpur, Rajasthan, India
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Kapatia G, Saha A, Rohilla M, Gupta P, Gupta N, Srinivasan R, Rajwanshi A, Dey P. Clinical and Morphological Spectrum of Histoplasmosis on Cytology Along with the Review of Literature. Acta Cytol 2020; 64:532-538. [PMID: 32702707 DOI: 10.1159/000509151] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/30/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the study was to study the clinical and morphological spectrum of histoplasmosis diagnosed by fine needle aspiration cytology (FNAC). STUDY DESIGN A total of 17 patients diagnosed with histoplasmosis on FNAC were studied over a period of 5 years. The cytology smears were studied and analysed for the cytomorphological spectrum of histoplasmosis. RESULTS Among the 17 patients studied, the mean age was 51.3 years (range 6-84 years). Male-to-female ratio was 3.25:1 with 4 females and 13 males. The frequent sites of involvement were the lung (5), lymph node (4), adrenal gland (4), and skin (4). The most common cytological patterns were histiocytic collection, followed by granulomas and multinucleated giant cells. Necrosis was noted in only 4 cases. CONCLUSION Fine needle aspiration is a highly accurate, rapid, and cheap technique for the diagnosis of histoplasmosis due to its distinct morphological features.
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Affiliation(s)
- Gargi Kapatia
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashmita Saha
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manish Rohilla
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Parikshaa Gupta
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nalini Gupta
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Radhika Srinivasan
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Arvind Rajwanshi
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranab Dey
- Department of Cytology, Post Graduate Institute of Medical Education and Research, Chandigarh, India,
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Lin MJ, Mazzoni D, Gin D. Disseminated cutaneous-only histoplasmosis in a patient with AIDS. Australas J Dermatol 2019; 60:e330-e332. [PMID: 31250916 DOI: 10.1111/ajd.13108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/29/2019] [Indexed: 11/26/2022]
Abstract
Histoplasmosis is an opportunistic fungal infection that occurs predominantly in immunocompromised patients. Cutaneous lesions in histoplasmosis are rare and typically occur in the absence of extra-cutaneous manifestations. We present a rare case of disseminated cutaneous-only histoplasmosis in a patient with recently diagnosed AIDS.
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Affiliation(s)
| | | | - Douglas Gin
- The Alfred Hospital, Prahran, Victoria, Australia
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Sirait SP, Bramono K, Hermanto N. Correlation of CD4 counts with clinical and histopathological findings in disseminated histoplasmosis: a 10-year retrospective study. Int J Dermatol 2017; 56:926-931. [PMID: 28677260 DOI: 10.1111/ijd.13679] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Revised: 05/01/2017] [Accepted: 05/22/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Disseminated cutaneous histoplasmosis (DCH) is one of the manifestations of systemic histoplasmosis infection in HIV-positive patients. Interaction between host immune status and histoplasmosis infection is still poorly understood. It is thought that immune status, represented by CD4 counts, may be correlated with clinical and histopathological findings. OBJECTIVE To correlate the CD4 counts with the different clinical and histopathological findings in cutaneous histoplasmosis. METHODS This was a serial case report of seven HAART-treated HIV positive patients with disseminated histoplasmosis observed within the period of January 2004 through December 2014 from the Dermatology and Venereology Department, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The patients came with different complaints and clinical findings. CD4 counts were recorded prior to lesion biopsy. RESULTS The CD4 counts were independent from clinical morphology and distribution of lesions. Lower CD4 counts were associated with the presence of intraepidermal yeast-like cells, whereas there is the ability of forming granulomas at higher CD4 counts. CONCLUSION CD4 count correlates to histopathological findings of cutaneous histoplasmosis.
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Affiliation(s)
- Sondang P Sirait
- Department of Dermatovenerology, Medical Faculty Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Kusmarinah Bramono
- Department of Dermatovenerology, Medical Faculty Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Nathalia Hermanto
- Department of Dermatovenerology, Medical Faculty Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Kumari M, Udayakumar M, Kaushal M, Madaan GB. Unusual presentation of disseminated histoplasmosis in an immunocompetent patient. Diagn Cytopathol 2017; 45:848-850. [DOI: 10.1002/dc.23742] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 04/10/2017] [Accepted: 04/18/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Manju Kumari
- Department of pathology; PGIMER, Dr. RML Hospital; New Delhi India
| | | | - Manju Kaushal
- Department of pathology; PGIMER, Dr. RML Hospital; New Delhi India
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Mishra DP, Ramamurthy S, Behera SK. Histoplasmosis presenting as isolated cervical lymphadenopathy: A rare presentation. J Cytol 2015; 32:188-90. [PMID: 26729981 PMCID: PMC4687211 DOI: 10.4103/0970-9371.168855] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Histoplasmosis is an opportunistic fungal infection caused by inhaling the spores of a fungus called Histoplasma capsulatum. Disseminated histoplasmosis is the most common form associated with acquired immune deficiency syndrome (AIDS). Here, we report a case of histoplasmosis presenting as isolated cervical lymphadenopathy in a human immunodeficiency virus (HIV)-infected patient diagnosed by a less invasive method (fine-needle aspiration cytology) and confirmed by fungal culture of fine-needle aspiration material. Due to varied and nonspecific clinical manifestations of histoplasmosis, most of the infections are misdiagnosed or underreported. It has to be considered in differential diagnosis of cervical lymphadenopathy, particularly in immunocompromised patients so that patients can be treated medically at an early stage before dissemination occurs and unnecessary surgery can be avoided. Here, we present this case because of its rare presentation as isolated cervical lymphadenopathy and classical cytological picture.
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Affiliation(s)
- Debi Prasad Mishra
- Department of Pathology, The Maharaja Krishna Chandra Gajapati Medical College, Berhampur, Odisha, India
| | - Sindhu Ramamurthy
- Department of Pathology, The Maharaja Krishna Chandra Gajapati Medical College, Berhampur, Odisha, India
| | - Samir Kumar Behera
- Department of Pathology, The Maharaja Krishna Chandra Gajapati Medical College, Berhampur, Odisha, India
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Abstract
A patient presented with multiple nodulo-ulcerative lesions over neck and chest. Lymphadenopathy and systemic involvement were absent. Patient was seronegative for HIV. There was no history of local injury and no history of travel. Histopathological findings were consistent with histoplasmosis. Diagnosis of primary cutaneous histoplasmosis was made. We highlight this case owing to its rare and atypical presentation, in an attempt to promote clinical and micro-pathological awareness regarding such occurrences.
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Affiliation(s)
- Nandita Pal
- Department of Microbiology, College of Medicine and Sagore Dutta Hospital, Kamarhati, Kolkata, West Bengal, India
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Mohammed S, Sinha M, Chavan P, Premalata C, Shivaprakash M, Chakrabarti A, Jayshree RS. Oral histoplasmosis masquerading as oral cancer in HIV-infected patient: A case report. Med Mycol Case Rep 2012; 1:85-7. [PMID: 24371747 DOI: 10.1016/j.mmcr.2012.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Revised: 09/04/2012] [Accepted: 09/06/2012] [Indexed: 11/18/2022] Open
Abstract
Histoplasmosis is an endemic mycoses caused by Histoplasma capsulatum with endemicity around midwestern United States and central America. The endemicity of histoplasmosis in India is not clearly known. Histoplasmosis, especially oral histoplasmosis, is now increasingly being reported from India. We report here a culture-confirmed and sequence confirmed, oral histoplasmosis in a HIV seropositive individual who was referred to our regional cancer centre with a suspicion of oral cancer.
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Affiliation(s)
- Shafiulla Mohammed
- Department of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore 560029, India
| | - Mahua Sinha
- Department of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore 560029, India
| | - Purushottam Chavan
- Department of Head and Neck Surgery, Kidwai Memorial Institute of Oncology, Bangalore 560029, India
| | - Cs Premalata
- Department of Pathology, Kidwai Memorial Institute of Oncology, Dr MH Marigowda Road, Bangalore 560029, India
| | - Mr Shivaprakash
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh 160012, India
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education & Research, Sector 12, Chandigarh 160012, India
| | - Rudrapatna S Jayshree
- Department of Microbiology, Kidwai Memorial Institute of Oncology, Bangalore 560029, India
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Beirão F, Araujo R. State of the art diagnostic of mold diseases: a practical guide for clinicians. Eur J Clin Microbiol Infect Dis 2012; 32:3-9. [DOI: 10.1007/s10096-012-1722-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Accepted: 08/01/2012] [Indexed: 11/28/2022]
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Arghya B, Kaushik M, Mimi G, Subrata C. Cytodiagnosis of cutaneous histoplasmosis in HIV positive patient initially presenting with multiple umbilicated disseminated skin nodules. Diagn Cytopathol 2011; 41:459-62. [DOI: 10.1002/dc.21814] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Accepted: 07/09/2011] [Indexed: 11/10/2022]
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