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Heilmann RM, Nabity MB, Bryan LK, Cook AK, Scott K. Mucocutaneous nasal histoplasmosis in an immunocompetent dog. BMC Vet Res 2021; 17:192. [PMID: 33985507 PMCID: PMC8120838 DOI: 10.1186/s12917-021-02896-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/04/2021] [Indexed: 11/24/2022] Open
Abstract
Background Histoplasma (H.) capsulatum is a dimorphic fungus, and infection is typically via inhalation of microconidia. After conversion to the yeast phase within the lung, the organism is subsequently disseminated to other tissues by macrophages. Nasal histoplasmosis appears to be a rare condition in dogs. Case presentation We report the clinical case of a 4.5-year-old male neutered Cocker spaniel/Poodle mix, 7.7 kg, body condition score 6/9, that presented with a 3-month history of sneezing and left-sided mucoid nasal discharge. The history also included a mild swelling (transient) of the right carpus with a lameness (grade II-III/IV), coinciding with the onset of sneezing and nasal discharge. The dog lived primarily indoors in the Texas Gulf Coast area. On physical examination, the dog was febrile, and the left nostril was swollen, ulcerative, deformed, and hypopigmented. Mandibular lymph nodes were firm and mildly enlarged bilaterally. Mild lymphopenia, thrombocytopenia, and hyperglobulinemia were noted. Thoracic radiographs were unremarkable. Computed tomography and rhinoscopy revealed swelling of the rostral portion of the left and right nasal passages. Cytology and histology of biopsies of the affected nasal tissue showed pyogranulomatous inflammation and yeast organisms consistent with H. capsulatum. Weak antigenuria was detected on the MVista H. capsulatum antigen test. Treatment with oral itraconazole led to a resolution of the nasal signs and normalization of the appearance of the nostril over 13 weeks, and neither antigenuria nor antigenemia was detected on several recheck examinations. The dog remained in good general and physical condition and showed no signs of disease recurrence more than 6 years after the last examination. Conclusion We report a rare case of nasal mucocutaneous histoplasmosis in an immunocompetent dog, with an excellent clinical response to oral itraconazole. This case documents that histoplasmosis in dogs can affect primarily the nasal cavity, which responds rapidly to triazole antifungal therapy and has a good prognosis. A similar case has only been reported in human medicine in a young adult.
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Affiliation(s)
- Romy M Heilmann
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843, USA. .,Department for Small Animals, Veterinary Teaching Hospital, College of Veterinary Medicine, University of Leipzig, An den Tierkliniken 23, DE-04103, Leipzig, SN, Germany.
| | - Mary B Nabity
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TAMU 4474, College Station, TX, 77843, USA
| | - Laura K Bryan
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, TAMU 4474, College Station, TX, 77843, USA
| | - Audrey K Cook
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843, USA
| | - Katherine Scott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843, USA.,VCA Alameda East Veterinary Hospital, 9770 E Alameda Ave, Denver, CO, 80247, USA
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Pineda J, Merino-Alado R, Mata-Essayag S, Landaeta ME, Garrido L, Rosas MDM. Nasal Septum Perforation Associated to Histoplasmosis: A Retrospective Study. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2020. [DOI: 10.1590/pboci.2020.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Lehur AC, Zielinski M, Pluvy J, Grégoire V, Diamantis S, Bleibtreu A, Rioux C, Picard A, Vallois D. Case of disseminated histoplasmosis in a HIV-infected patient revealed by nasal involvement with maxillary osteolysis. BMC Infect Dis 2017; 17:328. [PMID: 28476105 PMCID: PMC5418854 DOI: 10.1186/s12879-017-2419-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 04/25/2017] [Indexed: 11/10/2022] Open
Abstract
Background Disseminated Histoplasmosis (DH) is a rare manifestation of Acquired Immune Deficiency Syndrome (AIDS) in European countries. Naso-maxillar osteolysis due to Histoplasma capsulatum var. capsulatum (Hcc) is unusual in endemic countries and has never been reported in European countries. Differential diagnoses such as malignant tumors, cocaine use, granulomatosis, vasculitis and infections are more frequently observed and could delay and/or bias the final diagnosis. Case presentation We report the case of an immunocompromised patient infected by Human Immunodeficiency Virus (HIV) with naso-maxillar histoplasmosis in a non-endemic country. Our aim is to describe the clinical presentation, the diagnostic and therapeutic issues. A 53-year-old woman, originated from Haiti, was admitted in 2016 for nasal deformation with alteration of general condition evolving for at least 6 months. HIV infection was diagnosed in 2006 and classified at AIDS stage in 2008 due to cytomegalovirus infection associated with pulmonary histoplasmosis. At admission, CD4 cell count was 9/mm3. Surgical biopsies were performed and ruled out differential or associated diagnoses. Mycological cultures identified Hcc and Blood Polymerase Chain Reaction (PCR) for Hcc was positive. The patient was given daily Amphothericin B liposomal infusion during 1 month. Hcc PCR became negative in the blood under treatment, and then oral switch by itraconazole was introduced. Antiretroviral treatment was reintroduced after a 3-week histoplasmosis treatment. Normalization of naso-maxillar mucosa enabled a palatal prosthesis. Conclusion Naso-maxillar histoplasmosis is extremely rare; this is the first case ever reported in a non-endemic country. Differential diagnoses must be ruled out by conducting microbiologic tools and histological examinations on surgical biopsies. Early antifungal treatment should be initiated in order to prevent DH severe outcomes.
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Affiliation(s)
- A C Lehur
- Infectious and Tropical Diseases Department, University Hospital Bichat-Claude Bernard, APHP, 46 rue Henri Huchard, 75018, Paris, France
| | - M Zielinski
- Otorhinolaryngology Department, University Hospital Bichat-Claude Bernard, APHP, Paris, France
| | - J Pluvy
- Infectious and Tropical Diseases Department, University Hospital Bichat-Claude Bernard, APHP, 46 rue Henri Huchard, 75018, Paris, France
| | - V Grégoire
- Hematology Department, Meaux Hospital, Meaux, France
| | - S Diamantis
- General Medecine and Infectious Diseases Department, Melun Hospital, Melun, France
| | - A Bleibtreu
- Infectious and Tropical Diseases Department, University Hospital Bichat-Claude Bernard, APHP, 46 rue Henri Huchard, 75018, Paris, France
| | - C Rioux
- Infectious and Tropical Diseases Department, University Hospital Bichat-Claude Bernard, APHP, 46 rue Henri Huchard, 75018, Paris, France
| | - A Picard
- Otorhinolaryngology Department, University Hospital Bichat-Claude Bernard, APHP, Paris, France
| | - D Vallois
- Infectious and Tropical Diseases Department, University Hospital Bichat-Claude Bernard, APHP, 46 rue Henri Huchard, 75018, Paris, France.
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Samantaray S, Panda S, Dash S, Rout N. Role of fine-needle aspiration cytology in diagnosis of disseminated histoplasmosis in an immunocompetent patient: A case report. J Cytol 2017; 34:156-158. [PMID: 28701830 PMCID: PMC5492754 DOI: 10.4103/joc.joc_74_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Histoplasmosis is a mycotic infection caused by dimorphic fungus, Histoplasma capsulatum. The organisms are usually found within the cells (macrophages). This organism mostly affects lungs in immunocompetent individuals and disseminated forms are seen in immunocompromised cases. Here, we describe a case of disseminated histoplasmosis in an immunocompetent, 35-year-old female with lymphadenopathy diagnosed by fine-needle aspiration cytology and cell block.
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Affiliation(s)
- Sagarika Samantaray
- Department of Pathology, A.H. Regional Cancer Centre, Cuttack, Odisha, India
| | - Sasmita Panda
- Department of Pathology, A.H. Regional Cancer Centre, Cuttack, Odisha, India
| | - Sashibhusan Dash
- Department of Pathology, A.H. Regional Cancer Centre, Cuttack, Odisha, India
| | - Niranjan Rout
- Department of Pathology, A.H. Regional Cancer Centre, Cuttack, Odisha, India
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Raina RK, Mahajan V, Sood A, Saurabh S. Primary Cutaneous Histoplasmosis in an Immunocompetent Host from a Nonendemic Area. Indian J Dermatol 2016; 61:467. [PMID: 27512207 PMCID: PMC4966422 DOI: 10.4103/0019-5154.185748] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
A 32-year-old male presented to Dermatology outpatient Department with complaints of a single nonhealing ulcer on his right thigh. This lesion was there for the last 1 months. It had begun as a small nodule and increased up to the present size of 3 cm with an oozing and ulcerated surface and thickened everted margins. The systemic investigations were normal which included hemogram, biochemistry, including liver and renal function tests, chest X-ray, ultrasonography of abdomen, computed tomography of the thorax, and abdomen. Skin biopsy revealed multiple rounds to oval spores with surrounding halo intracellularly as well as extracellularly. A diagnosis of deep fungal infection as histoplasmosis was made and confirmed on culture.
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Affiliation(s)
- Rashmi Kaul Raina
- Department of Pathology, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
| | - Vikram Mahajan
- Department of Dermatology, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
| | - Anuradha Sood
- Department of Microbiology, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
| | - Sharma Saurabh
- Department of Pathology, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India
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Laudien M. Orphan diseases of the nose and paranasal sinuses: Pathogenesis - clinic - therapy. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2015; 14:Doc04. [PMID: 26770278 PMCID: PMC4702053 DOI: 10.3205/cto000119] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Rare rhinological diseases are a diagnostic challenge. Sometimes it takes months or even years from the primary manifestation of the disease until the definitive diagnosis is establibshed. During these times the disease proceeds in an uncontrolled or insufficiently treated way. (Irreversible) damage results and sometimes life-threatening situations occur. The unexpected course of a (misdiagnosed) disease should lead to further diagnostic reflections and steps in order to detect also rare diseases as early as possible. The present paper discusses granulomatous diseases of the nose and paranasal sinuses caused by mycobacteria, treponema, Klebsiella, fungi, and protozoa as well as vasculitis, sarcoidosis, rosacea, cocaine-induced midline destruction, nasal extranodal NK/T cell lymphoma, and cholesterol granuloma. Furthermore, diseases with disorders of the mucociliary clearance such as primary ciliary dyskinesia and cystic fibrosis are presented, taking into consideration the current literature.
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Affiliation(s)
- Martin Laudien
- Department of Otorhinolaryngology, Head & Neck Surgery, University Medicine of Kiel, Christian-Albrechts-University, Kiel, Germany
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Kathuria S, Capoor MR, Yadav S, Singh A, Ramesh V. Disseminated histoplasmosis in an apparently immunocompetent individual from north India: a case report and review. Med Mycol 2013; 51:774-8. [DOI: 10.3109/13693786.2013.777166] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Manzini M, Lavinsky-Wolff M. Nasal histoplasmosis without lung involvement in an immunocompromised patient. Braz J Otorhinolaryngol 2013; 78:136. [PMID: 23108834 PMCID: PMC9450768 DOI: 10.5935/1808-8694.20120022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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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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Vasudevan B, Ashish B, Amitabh S, A P M. Primary Cutaneous Histoplasmosis in a HIV-Positive Individual. J Glob Infect Dis 2011; 2:112-5. [PMID: 20606964 PMCID: PMC2889648 DOI: 10.4103/0974-777x.62884] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
A 31-year-old human immunodeficiency virus-positive male who presented to the Dermatology Outpatient Department with complaints of red, raised lesions on the face of 2 weeks duration was, on examination, found to have multiple papulonodular lesions on the face with associated cervical and axillary lymphadenopathy. There was history of local injury on the face 6 months prior to the development of symptoms. Skin biopsy revealed multiple round to oval spores with surrounding halo intracellularly, confirming the diagnosis of cutaneous histoplasmosis. No systemic involvement was detected on further investigations. The patient responded to oral antifungals in a short duration, confirming the local nature of the presentation. This is probably the first time in the literature that a primary cutaneous manifestation of histoplasmosis is being described in an immunocompromised individual.
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Affiliation(s)
- Biju Vasudevan
- Department of Dermatology, MH Shillong, Shillong, Meghalaya, India
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Rappo U, Beitler J, Faulhaber J, Firoz B, Henning J, Thomas K, Maslow M, Goldfarb D, Horowitz H. Expanding the horizons of histoplasmosis: disseminated histoplasmosis in a renal transplant patient after a trip to Bangladesh. Transpl Infect Dis 2010; 12:155-60. [DOI: 10.1111/j.1399-3062.2009.00466.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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