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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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Infectious Diseases |
| Online Access: | http://dx.doi.org/10.1155/2019/7403878 |
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| author | Chiara Papalini Barbara Belfiori Giovanni Martino Rita Papili Lucia Pitzurra Stefano Ascani Maria Bruna Pasticci |
| author_facet | Chiara Papalini Barbara Belfiori Giovanni Martino Rita Papili Lucia Pitzurra Stefano Ascani Maria Bruna Pasticci |
| author_sort | Chiara Papalini |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-bc91070a9d734441b31e9a173ddf050d |
| institution | OA Journals |
| issn | 2090-6625 2090-6633 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Infectious Diseases |
| spelling | doaj-art-bc91070a9d734441b31e9a173ddf050d2025-08-20T02:18:50ZengWileyCase Reports in Infectious Diseases2090-66252090-66332019-01-01201910.1155/2019/74038787403878An Italian Case of Disseminated Histoplasmosis Associated with HIVChiara Papalini0Barbara Belfiori1Giovanni Martino2Rita Papili3Lucia Pitzurra4Stefano Ascani5Maria Bruna Pasticci6Infectious Diseases Clinic, Perugia University, S. Maria della Misericordia Hospital, Perugia 06132, ItalyInfectious Diseases Clinic, Perugia University, S. Maria della Misericordia Hospital, Perugia 06132, ItalyHematology Clinic, Perugia University, S. Maria della Misericordia Hospital, Perugia 06132, ItalyInfectious Diseases Clinic, Perugia University, S. Maria della Misericordia Hospital, Perugia 06132, ItalyMicrobiology Institute, Perugia University, S. Maria della Misericordia Hospital, Perugia 06132, ItalyHematology Clinic, Perugia University, S. Maria della Misericordia Hospital, Perugia 06132, ItalyInfectious Diseases Clinic, Perugia University, S. Maria della Misericordia Hospital, Perugia 06132, ItalyHistoplasma 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.http://dx.doi.org/10.1155/2019/7403878 |
| spellingShingle | Chiara Papalini Barbara Belfiori Giovanni Martino Rita Papili Lucia Pitzurra Stefano Ascani Maria Bruna Pasticci An Italian Case of Disseminated Histoplasmosis Associated with HIV Case Reports in Infectious Diseases |
| 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 |
| url | http://dx.doi.org/10.1155/2019/7403878 |
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