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An Italian Case of Disseminated Histoplasmosis Associated with HIV

Histoplasma capsulatum is a dimorphic fungus, endemic in the Americas, Africa (var. duboisii), India, and Southeast Asia. H. capsulatum infection is rarely diagnosed in Italy, while in Latin America, progressive disseminated histoplasmosis (PDH) is one of the most frequent AIDS-defining illnesses an...

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Autores principales: Papalini, Chiara, Belfiori, Barbara, Martino, Giovanni, Papili, Rita, Pitzurra, Lucia, Ascani, Stefano, Pasticci, Maria Bruna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885199/
https://www.ncbi.nlm.nih.gov/pubmed/31827952
http://dx.doi.org/10.1155/2019/7403878
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author Papalini, Chiara
Belfiori, Barbara
Martino, Giovanni
Papili, Rita
Pitzurra, Lucia
Ascani, Stefano
Pasticci, Maria Bruna
author_facet Papalini, Chiara
Belfiori, Barbara
Martino, Giovanni
Papili, Rita
Pitzurra, Lucia
Ascani, Stefano
Pasticci, Maria Bruna
author_sort Papalini, Chiara
collection PubMed
description Histoplasma capsulatum is a dimorphic fungus, endemic in the Americas, Africa (var. duboisii), India, and Southeast Asia. H. capsulatum infection is rarely diagnosed in Italy, while in Latin America, progressive disseminated histoplasmosis (PDH) is one of the most frequent AIDS-defining illnesses and causes of AIDS-related deaths. We report a case of PDH and new HIV infection diagnosis in a Cuban patient, who has been living in Italy for the past 10 years. Bone marrow aspirate and peripheral blood smear microscopy suggested H. capsulatum infection. The diagnosis was confirmed with the culture method identifying its thermal dimorphism. Liposomal amphotericin B was administered alone for 10 days and then for another 2 days, accompanied with voriconazole; the former was stopped for probable side effects (persistent fever and worsening thrombocytopenia), and voriconazole was continued to complete 4 weeks. PDH maintenance treatment consisted of itraconazole for one year. Antiretroviral therapy (ART) was started on the third week of antifungal treatment. At the 3-year follow-up, the patient is adherent on ART, the virus was suppressed, and she has an optimal immune recovery. This case highlights the need to suspect histoplasmosis in the differential diagnosis of opportunistic infections in immunocompromised persons, native to or who have traveled to endemic countries.
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spelling pubmed-68851992019-12-11 An Italian Case of Disseminated Histoplasmosis Associated with HIV Papalini, Chiara Belfiori, Barbara Martino, Giovanni Papili, Rita Pitzurra, Lucia Ascani, Stefano Pasticci, Maria Bruna Case Rep Infect Dis Case Report Histoplasma capsulatum is a dimorphic fungus, endemic in the Americas, Africa (var. duboisii), India, and Southeast Asia. H. capsulatum infection is rarely diagnosed in Italy, while in Latin America, progressive disseminated histoplasmosis (PDH) is one of the most frequent AIDS-defining illnesses and causes of AIDS-related deaths. We report a case of PDH and new HIV infection diagnosis in a Cuban patient, who has been living in Italy for the past 10 years. Bone marrow aspirate and peripheral blood smear microscopy suggested H. capsulatum infection. The diagnosis was confirmed with the culture method identifying its thermal dimorphism. Liposomal amphotericin B was administered alone for 10 days and then for another 2 days, accompanied with voriconazole; the former was stopped for probable side effects (persistent fever and worsening thrombocytopenia), and voriconazole was continued to complete 4 weeks. PDH maintenance treatment consisted of itraconazole for one year. Antiretroviral therapy (ART) was started on the third week of antifungal treatment. At the 3-year follow-up, the patient is adherent on ART, the virus was suppressed, and she has an optimal immune recovery. This case highlights the need to suspect histoplasmosis in the differential diagnosis of opportunistic infections in immunocompromised persons, native to or who have traveled to endemic countries. Hindawi 2019-11-16 /pmc/articles/PMC6885199/ /pubmed/31827952 http://dx.doi.org/10.1155/2019/7403878 Text en Copyright © 2019 Chiara Papalini et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Papalini, Chiara
Belfiori, Barbara
Martino, Giovanni
Papili, Rita
Pitzurra, Lucia
Ascani, Stefano
Pasticci, Maria Bruna
An Italian Case of Disseminated Histoplasmosis Associated with HIV
title An Italian Case of Disseminated Histoplasmosis Associated with HIV
title_full An Italian Case of Disseminated Histoplasmosis Associated with HIV
title_fullStr An Italian Case of Disseminated Histoplasmosis Associated with HIV
title_full_unstemmed An Italian Case of Disseminated Histoplasmosis Associated with HIV
title_short An Italian Case of Disseminated Histoplasmosis Associated with HIV
title_sort italian case of disseminated histoplasmosis associated with hiv
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6885199/
https://www.ncbi.nlm.nih.gov/pubmed/31827952
http://dx.doi.org/10.1155/2019/7403878
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