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Chronic Cavitary Pulmonary Histoplasmosis in an Immunocompetent Patient
Histoplasma capsulatum is a fungal organism that causes systemic histoplasmosis. It is commonly asymptomatic in healthy immunocompetent individuals. The clinical symptoms of chronic cavitary histoplasmosis are typically seen in the immunodeficient population, particularly in smokers with pre-existin...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158553/ https://www.ncbi.nlm.nih.gov/pubmed/37153264 http://dx.doi.org/10.7759/cureus.37095 |
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author | Albandak, Maram Azar, Jehad Ayyad, Mohammed Salah, Qais Toqan, Anas Giacaman, Narmeen Marzouqa, Nizar Al-Tawil, Mohammed Wishah, Bisan Barabrah, Anas |
author_facet | Albandak, Maram Azar, Jehad Ayyad, Mohammed Salah, Qais Toqan, Anas Giacaman, Narmeen Marzouqa, Nizar Al-Tawil, Mohammed Wishah, Bisan Barabrah, Anas |
author_sort | Albandak, Maram |
collection | PubMed |
description | Histoplasma capsulatum is a fungal organism that causes systemic histoplasmosis. It is commonly asymptomatic in healthy immunocompetent individuals. The clinical symptoms of chronic cavitary histoplasmosis are typically seen in the immunodeficient population, particularly in smokers with pre-existing structural lung disease. We report a case of chronic cavitary histoplasmosis in an immunocompetent patient from an endemic area without pre-existing structural lung pathology. She presented complaining of right hypochondrial pain and had no history of respiratory symptoms nor history suggestive of immunosuppression, tuberculosis, or recent travel. CT scan revealed a cavitary lung lesion and a hilar mediastinal mass. Biopsies obtained by bronchoscopy revealed signs of necrosis, granulomas, and the presence of fungal organisms consistent with histoplasmosis. Histoplasma antibodies by complement fixation for yeast antibodies test were positive establishing the diagnosis of chronic cavitary pulmonary histoplasmosis (CCPH). She was then started on itraconazole with good tolerance. On follow-up three months later, a chest CT done along with measurement of inflammatory markers and liver enzymes demonstrated complete clinical recovery. This case emphasizes the importance of expanding our current understanding of the clinical presentation and manifestations of histoplasmosis beyond the conventional assumption that severe disease only affects immunocompromised individuals. |
format | Online Article Text |
id | pubmed-10158553 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-101585532023-05-05 Chronic Cavitary Pulmonary Histoplasmosis in an Immunocompetent Patient Albandak, Maram Azar, Jehad Ayyad, Mohammed Salah, Qais Toqan, Anas Giacaman, Narmeen Marzouqa, Nizar Al-Tawil, Mohammed Wishah, Bisan Barabrah, Anas Cureus Internal Medicine Histoplasma capsulatum is a fungal organism that causes systemic histoplasmosis. It is commonly asymptomatic in healthy immunocompetent individuals. The clinical symptoms of chronic cavitary histoplasmosis are typically seen in the immunodeficient population, particularly in smokers with pre-existing structural lung disease. We report a case of chronic cavitary histoplasmosis in an immunocompetent patient from an endemic area without pre-existing structural lung pathology. She presented complaining of right hypochondrial pain and had no history of respiratory symptoms nor history suggestive of immunosuppression, tuberculosis, or recent travel. CT scan revealed a cavitary lung lesion and a hilar mediastinal mass. Biopsies obtained by bronchoscopy revealed signs of necrosis, granulomas, and the presence of fungal organisms consistent with histoplasmosis. Histoplasma antibodies by complement fixation for yeast antibodies test were positive establishing the diagnosis of chronic cavitary pulmonary histoplasmosis (CCPH). She was then started on itraconazole with good tolerance. On follow-up three months later, a chest CT done along with measurement of inflammatory markers and liver enzymes demonstrated complete clinical recovery. This case emphasizes the importance of expanding our current understanding of the clinical presentation and manifestations of histoplasmosis beyond the conventional assumption that severe disease only affects immunocompromised individuals. Cureus 2023-04-04 /pmc/articles/PMC10158553/ /pubmed/37153264 http://dx.doi.org/10.7759/cureus.37095 Text en Copyright © 2023, Albandak et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Internal Medicine Albandak, Maram Azar, Jehad Ayyad, Mohammed Salah, Qais Toqan, Anas Giacaman, Narmeen Marzouqa, Nizar Al-Tawil, Mohammed Wishah, Bisan Barabrah, Anas Chronic Cavitary Pulmonary Histoplasmosis in an Immunocompetent Patient |
title | Chronic Cavitary Pulmonary Histoplasmosis in an Immunocompetent Patient |
title_full | Chronic Cavitary Pulmonary Histoplasmosis in an Immunocompetent Patient |
title_fullStr | Chronic Cavitary Pulmonary Histoplasmosis in an Immunocompetent Patient |
title_full_unstemmed | Chronic Cavitary Pulmonary Histoplasmosis in an Immunocompetent Patient |
title_short | Chronic Cavitary Pulmonary Histoplasmosis in an Immunocompetent Patient |
title_sort | chronic cavitary pulmonary histoplasmosis in an immunocompetent patient |
topic | Internal Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10158553/ https://www.ncbi.nlm.nih.gov/pubmed/37153264 http://dx.doi.org/10.7759/cureus.37095 |
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