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Disseminated Histoplasmosis in an Indigenous Child With Malnutrition: A Case Report

Histoplasmosis is a mycosis caused by Histoplasma capsulatum, a dimorphic fungus endemic to areas with nitrogen-rich soil, like the one contaminated with bird and bat excrement. Patients with a deficient immune response are especially at risk for developing invasive infections, such as disseminated...

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Autores principales: Yglesias Dimadi, Ioanna I, Clinton Hidalgo, Madelyn, Hernández Chavarría, Vivian I, Min Kim, Hery, Castro Torres, Grettel R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10404342/
https://www.ncbi.nlm.nih.gov/pubmed/37551207
http://dx.doi.org/10.7759/cureus.41493
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author Yglesias Dimadi, Ioanna I
Clinton Hidalgo, Madelyn
Hernández Chavarría, Vivian I
Min Kim, Hery
Castro Torres, Grettel R
author_facet Yglesias Dimadi, Ioanna I
Clinton Hidalgo, Madelyn
Hernández Chavarría, Vivian I
Min Kim, Hery
Castro Torres, Grettel R
author_sort Yglesias Dimadi, Ioanna I
collection PubMed
description Histoplasmosis is a mycosis caused by Histoplasma capsulatum, a dimorphic fungus endemic to areas with nitrogen-rich soil, like the one contaminated with bird and bat excrement. Patients with a deficient immune response are especially at risk for developing invasive infections, such as disseminated histoplasmosis, and secondary immunodeficiency can be a consequence of malnutrition. This case report presents a 15-month-old male infant with malnutrition who presented with signs and symptoms of disseminated histoplasmosis, including fever, malaise, weight loss, cough, and diarrhea. The infant came from a geographic area where histoplasmosis is endemic, and he was a member of a cultural group with a higher prevalence of histoplasmosis than the general population. On physical examination, hepatosplenomegaly, lymphadenopathy, and lung crackles were found, which are common in most patients with histoplasmosis. The keystone of diagnosis of H. capsulatum infection is antigen detection, but the criterion standard is isolation of the organism from body specimens through laboratory culture. Histological diagnosis is especially useful for rapid diagnosis. Treatment of disseminated histoplasmosis in the pediatric population consists of deoxycholate amphotericin B for four to six weeks followed by itraconazole to complete a total of three months of treatment. Despite the involvement of multiple organ systems, the patient recovered satisfactorily after the completion of amphotericin B treatment for one month and the resolution of his malnourishment.
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spelling pubmed-104043422023-08-07 Disseminated Histoplasmosis in an Indigenous Child With Malnutrition: A Case Report Yglesias Dimadi, Ioanna I Clinton Hidalgo, Madelyn Hernández Chavarría, Vivian I Min Kim, Hery Castro Torres, Grettel R Cureus Pediatrics Histoplasmosis is a mycosis caused by Histoplasma capsulatum, a dimorphic fungus endemic to areas with nitrogen-rich soil, like the one contaminated with bird and bat excrement. Patients with a deficient immune response are especially at risk for developing invasive infections, such as disseminated histoplasmosis, and secondary immunodeficiency can be a consequence of malnutrition. This case report presents a 15-month-old male infant with malnutrition who presented with signs and symptoms of disseminated histoplasmosis, including fever, malaise, weight loss, cough, and diarrhea. The infant came from a geographic area where histoplasmosis is endemic, and he was a member of a cultural group with a higher prevalence of histoplasmosis than the general population. On physical examination, hepatosplenomegaly, lymphadenopathy, and lung crackles were found, which are common in most patients with histoplasmosis. The keystone of diagnosis of H. capsulatum infection is antigen detection, but the criterion standard is isolation of the organism from body specimens through laboratory culture. Histological diagnosis is especially useful for rapid diagnosis. Treatment of disseminated histoplasmosis in the pediatric population consists of deoxycholate amphotericin B for four to six weeks followed by itraconazole to complete a total of three months of treatment. Despite the involvement of multiple organ systems, the patient recovered satisfactorily after the completion of amphotericin B treatment for one month and the resolution of his malnourishment. Cureus 2023-07-07 /pmc/articles/PMC10404342/ /pubmed/37551207 http://dx.doi.org/10.7759/cureus.41493 Text en Copyright © 2023, Yglesias Dimadi 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 Pediatrics
Yglesias Dimadi, Ioanna I
Clinton Hidalgo, Madelyn
Hernández Chavarría, Vivian I
Min Kim, Hery
Castro Torres, Grettel R
Disseminated Histoplasmosis in an Indigenous Child With Malnutrition: A Case Report
title Disseminated Histoplasmosis in an Indigenous Child With Malnutrition: A Case Report
title_full Disseminated Histoplasmosis in an Indigenous Child With Malnutrition: A Case Report
title_fullStr Disseminated Histoplasmosis in an Indigenous Child With Malnutrition: A Case Report
title_full_unstemmed Disseminated Histoplasmosis in an Indigenous Child With Malnutrition: A Case Report
title_short Disseminated Histoplasmosis in an Indigenous Child With Malnutrition: A Case Report
title_sort disseminated histoplasmosis in an indigenous child with malnutrition: a case report
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10404342/
https://www.ncbi.nlm.nih.gov/pubmed/37551207
http://dx.doi.org/10.7759/cureus.41493
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