Disseminated histoplasmosis from western Mexico—rethinking our geographic distribution of endemic fungal species: a case report and review of literature
Abstract Background Histoplasma is a fungal pathogen found in many parts of the world. In North America, its distribution is traditionally thought to be endemic to the Ohio and Mississippi River valleys. Development of histoplasmosis after Histoplasma exposure is related to degree of inoculum exposu...
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2024-11-01
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| Online Access: | https://doi.org/10.1186/s13256-024-04856-x |
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| author | Richard Sleightholm Daniel Z. Hodson Isabella So Harshika Avula Jagmohan Batra |
| author_facet | Richard Sleightholm Daniel Z. Hodson Isabella So Harshika Avula Jagmohan Batra |
| author_sort | Richard Sleightholm |
| collection | DOAJ |
| description | Abstract Background Histoplasma is a fungal pathogen found in many parts of the world. In North America, its distribution is traditionally thought to be endemic to the Ohio and Mississippi River valleys. Development of histoplasmosis after Histoplasma exposure is related to degree of inoculum exposure and susceptibility, for example, immunocompromised status. Most exposed, healthy individuals are asymptomatic and few develop pulmonary symptoms. A limited number of infectious etiologies (that is, Histoplasma, Coccidioides, and Mycobacterium tuberculosis) can cause miliary pattern on chest imaging, and thus, histoplasmosis should be considered whenever a patient presents with pulmonary symptoms and these unique radiographic findings. Case presentation A previously healthy 13-year-old Hispanic male presented as a transfer from an outside hospital with fever and hypoxia in the setting of a progressive, subacute gastrointestinal illness. Given hypoxia, the concern for sepsis, and unclear etiology of his illness, broad-spectrum antimicrobial therapy and noninvasive ventilation were started. Initial evaluation demonstrated miliary pulmonary infiltrates, and travel history raised suspicion for coccidioidomycosis or tuberculosis. After a complete evaluation, lab studies confirmed a diagnosis of histoplasmosis, and the patient made a full recovery after the initiation and completion of antifungal therapy. Conclusion Herein, we present a patient who acquired histoplasmosis from an area of Mexico not currently acknowledged as endemic and review recently published data emphasizing new areas of Histoplasma endemicity in North America, particularly the southwest USA and most states of Mexico. Though limited surveillance data exist, mounting case reports/series and local epidemiologic studies illustrate the expanding worldwide endemicity of Histoplasma and underscore histoplasmosis as a growing global health concern. |
| format | Article |
| id | doaj-art-41dc2b375f984ca5bb23d0da18d83064 |
| institution | DOAJ |
| issn | 1752-1947 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | BMC |
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| series | Journal of Medical Case Reports |
| spelling | doaj-art-41dc2b375f984ca5bb23d0da18d830642025-08-20T02:49:59ZengBMCJournal of Medical Case Reports1752-19472024-11-011811910.1186/s13256-024-04856-xDisseminated histoplasmosis from western Mexico—rethinking our geographic distribution of endemic fungal species: a case report and review of literatureRichard Sleightholm0Daniel Z. Hodson1Isabella So2Harshika Avula3Jagmohan Batra4Department of Pediatrics, David Geffen School of Medicine, University of CaliforniaDivision of Internal Medicine-Pediatrics, David Geffen School of Medicine, University of CaliforniaDepartment of Pediatrics, David Geffen School of Medicine, University of CaliforniaDepartment of Pediatrics, David Geffen School of Medicine, University of CaliforniaDivision of Pediatric Infectious Diseases, Memorial Care Miller Children’s & Women’s Hospital Long Beach, Clinical Professor of Pediatrics, University of California Irvine Department of PediatricsAbstract Background Histoplasma is a fungal pathogen found in many parts of the world. In North America, its distribution is traditionally thought to be endemic to the Ohio and Mississippi River valleys. Development of histoplasmosis after Histoplasma exposure is related to degree of inoculum exposure and susceptibility, for example, immunocompromised status. Most exposed, healthy individuals are asymptomatic and few develop pulmonary symptoms. A limited number of infectious etiologies (that is, Histoplasma, Coccidioides, and Mycobacterium tuberculosis) can cause miliary pattern on chest imaging, and thus, histoplasmosis should be considered whenever a patient presents with pulmonary symptoms and these unique radiographic findings. Case presentation A previously healthy 13-year-old Hispanic male presented as a transfer from an outside hospital with fever and hypoxia in the setting of a progressive, subacute gastrointestinal illness. Given hypoxia, the concern for sepsis, and unclear etiology of his illness, broad-spectrum antimicrobial therapy and noninvasive ventilation were started. Initial evaluation demonstrated miliary pulmonary infiltrates, and travel history raised suspicion for coccidioidomycosis or tuberculosis. After a complete evaluation, lab studies confirmed a diagnosis of histoplasmosis, and the patient made a full recovery after the initiation and completion of antifungal therapy. Conclusion Herein, we present a patient who acquired histoplasmosis from an area of Mexico not currently acknowledged as endemic and review recently published data emphasizing new areas of Histoplasma endemicity in North America, particularly the southwest USA and most states of Mexico. Though limited surveillance data exist, mounting case reports/series and local epidemiologic studies illustrate the expanding worldwide endemicity of Histoplasma and underscore histoplasmosis as a growing global health concern.https://doi.org/10.1186/s13256-024-04856-xMycosesDisseminated histoplasmosisHistoplasma capsulatumChicken reservoirHistoplasma endemicity in MexicoGlobal health |
| spellingShingle | Richard Sleightholm Daniel Z. Hodson Isabella So Harshika Avula Jagmohan Batra Disseminated histoplasmosis from western Mexico—rethinking our geographic distribution of endemic fungal species: a case report and review of literature Journal of Medical Case Reports Mycoses Disseminated histoplasmosis Histoplasma capsulatum Chicken reservoir Histoplasma endemicity in Mexico Global health |
| title | Disseminated histoplasmosis from western Mexico—rethinking our geographic distribution of endemic fungal species: a case report and review of literature |
| title_full | Disseminated histoplasmosis from western Mexico—rethinking our geographic distribution of endemic fungal species: a case report and review of literature |
| title_fullStr | Disseminated histoplasmosis from western Mexico—rethinking our geographic distribution of endemic fungal species: a case report and review of literature |
| title_full_unstemmed | Disseminated histoplasmosis from western Mexico—rethinking our geographic distribution of endemic fungal species: a case report and review of literature |
| title_short | Disseminated histoplasmosis from western Mexico—rethinking our geographic distribution of endemic fungal species: a case report and review of literature |
| title_sort | disseminated histoplasmosis from western mexico rethinking our geographic distribution of endemic fungal species a case report and review of literature |
| topic | Mycoses Disseminated histoplasmosis Histoplasma capsulatum Chicken reservoir Histoplasma endemicity in Mexico Global health |
| url | https://doi.org/10.1186/s13256-024-04856-x |
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