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A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis—Molecular Diagnosis and Identification
Histoplasmosis is an endemic mycosis in the Americas. However, its diagnosis is challenging due to the complexity and limited availability of conventional laboratory techniques—antigen tests, culture, and staining. Microscopic preparations often confuse with other pathogens, such as Leishmania spp....
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538155/ https://www.ncbi.nlm.nih.gov/pubmed/37764920 http://dx.doi.org/10.3390/pathogens12091112 |
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author | Calvopiña, Manuel Toro, Marcelo Bastidas-Caldes, Carlos Vasco-Julio, David Muñoz, Greta |
author_facet | Calvopiña, Manuel Toro, Marcelo Bastidas-Caldes, Carlos Vasco-Julio, David Muñoz, Greta |
author_sort | Calvopiña, Manuel |
collection | PubMed |
description | Histoplasmosis is an endemic mycosis in the Americas. However, its diagnosis is challenging due to the complexity and limited availability of conventional laboratory techniques—antigen tests, culture, and staining. Microscopic preparations often confuse with other pathogens, such as Leishmania spp. The genus Histoplasma capsulatum comprises three varieties: var. capsulatum, var. duboissi, and var. farciminosum, which cannot be distinguished using conventional techniques. An infant from a tropical region of Ecuador was hospitalized for fever, bloody diarrhea, and anemia persisting for two months. Upon admission, he received antibiotics and immunosuppressants. Histopathological examination of the lymph nodes, intestines, and bone marrow aspirate reported the presence of Leishmania-like amastigotes, and treatment was initiated with meglumine antimoniate and conventional amphotericin B. However, subsequent analysis of samples using PCR and DNA sequencing identified H. capsulatum var. capsulatum but not Leishmania. Despite fluconazole and amphotericin B, the infant succumbed to the disease. The delay in clinical and laboratory diagnosis of histoplasmosis and the use of nonspecific and ineffective drugs such as fluconazole led to disease dissemination and, ultimately, death. Implementing molecular diagnosis and antigen tests in laboratories located in endemic regions and reference hospitals is crucial. |
format | Online Article Text |
id | pubmed-10538155 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-105381552023-09-29 A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis—Molecular Diagnosis and Identification Calvopiña, Manuel Toro, Marcelo Bastidas-Caldes, Carlos Vasco-Julio, David Muñoz, Greta Pathogens Case Report Histoplasmosis is an endemic mycosis in the Americas. However, its diagnosis is challenging due to the complexity and limited availability of conventional laboratory techniques—antigen tests, culture, and staining. Microscopic preparations often confuse with other pathogens, such as Leishmania spp. The genus Histoplasma capsulatum comprises three varieties: var. capsulatum, var. duboissi, and var. farciminosum, which cannot be distinguished using conventional techniques. An infant from a tropical region of Ecuador was hospitalized for fever, bloody diarrhea, and anemia persisting for two months. Upon admission, he received antibiotics and immunosuppressants. Histopathological examination of the lymph nodes, intestines, and bone marrow aspirate reported the presence of Leishmania-like amastigotes, and treatment was initiated with meglumine antimoniate and conventional amphotericin B. However, subsequent analysis of samples using PCR and DNA sequencing identified H. capsulatum var. capsulatum but not Leishmania. Despite fluconazole and amphotericin B, the infant succumbed to the disease. The delay in clinical and laboratory diagnosis of histoplasmosis and the use of nonspecific and ineffective drugs such as fluconazole led to disease dissemination and, ultimately, death. Implementing molecular diagnosis and antigen tests in laboratories located in endemic regions and reference hospitals is crucial. MDPI 2023-08-30 /pmc/articles/PMC10538155/ /pubmed/37764920 http://dx.doi.org/10.3390/pathogens12091112 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Calvopiña, Manuel Toro, Marcelo Bastidas-Caldes, Carlos Vasco-Julio, David Muñoz, Greta A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis—Molecular Diagnosis and Identification |
title | A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis—Molecular Diagnosis and Identification |
title_full | A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis—Molecular Diagnosis and Identification |
title_fullStr | A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis—Molecular Diagnosis and Identification |
title_full_unstemmed | A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis—Molecular Diagnosis and Identification |
title_short | A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis—Molecular Diagnosis and Identification |
title_sort | fatal case of disseminated histoplasmosis by histoplasma capsulatum var. capsulatum misdiagnosed as visceral leishmaniasis—molecular diagnosis and identification |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10538155/ https://www.ncbi.nlm.nih.gov/pubmed/37764920 http://dx.doi.org/10.3390/pathogens12091112 |
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