Related Experiment Videos
[Tibial abscess caused by histoplasma capsulatum]
M I de Fernández1, R Negroni, A Arechavala
1Microbiología, Instituto Quirúrgico del Callad, Buenos Aires. migf@infovia.com.ar
Abstract:
Disseminated histoplasmosis is the most serious form of the disease produced by the fungus Histoplasma capsulatum. Histoplasmosis was first described by Darling in 1906, and it is endemic in certain areas of Central and Southeastern regions of USA, and most Latin America countries, including the Pampa húmeda and Mesopotamia regions in Argentina, but in other continents it has a limited regional distribution. Lung involvement predominates in 90% of cases, but H. capsulatum may involve bone and soft tissues. Bone lesions without other signs of infection are very rare, and are often misdiagnosed as cancer. We report a case of disseminated histoplasmosis in a man with a myelodysplasia who presented a left tibial abscess, without any clinical evidence of pulmonary involvement. The patient was successfully treated with itraconazole.
Insights
Disseminated histoplasmosis, a severe fungal infection, can manifest as bone lesions without lung symptoms. This case highlights successful treatment of a tibial abscess caused by Histoplasma capsulatum with itraconazole.
Area of Science:
- Mycology
- Infectious Diseases
- Clinical Case Study
Background:
- Disseminated histoplasmosis, caused by Histoplasma capsulatum, is a severe systemic fungal infection.
- It is endemic in specific regions of the Americas, with lung involvement being most common (90%).
- Histoplasma capsulatum can affect bone and soft tissues, with bone lesions being rare and often misdiagnosed.
Observation:
- A case of disseminated histoplasmosis presented in a man with myelodysplasia.
- The patient exhibited a left tibial abscess.
- Crucially, there was no clinical evidence of pulmonary involvement.
Findings:
- The patient's tibial abscess was diagnosed as disseminated histoplasmosis.
- Bone involvement without pulmonary symptoms is a rare presentation of this fungal infection.
- The patient responded well to antifungal therapy.
Implications:
- This case underscores the importance of considering disseminated histoplasmosis in patients with bone lesions, even without apparent lung infection.
- Early diagnosis and appropriate treatment, such as with itraconazole, are crucial for favorable outcomes.
- Highlights the diagnostic challenge of rare presentations of endemic fungal infections.