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[Cutaneous Histoplasmosis and AIDS]
Miguel Reyes1, Luis Roberto Arenas, Patricia Pichardo
1Servicio de Medicina Interna, Hospital General Dr. Manuel Gea González, México, D.F. careyes@yahoo.com.mx
Abstract:
Histoplasmosis is usually a lung infection due to Histoplasma capsulatum var Capsulatum. Skin lesions are present in 10 to 17% of cases and it appears to have higher prevalence in Mexico. We report on three cases, all males with AIDS, of 26, 33 and 44 years of age. They presented fever, lymphadenopathy and weight loss. One had lingual ulcer and the other two, disseminated erythemato-violaceus plaques, papular and fistular lesions. The histopathologic study showed granulomatous lesions and Histoplasma capsulatum was isolated in cultures. All patients were treated successfully with amphotericin B with a total of 1.5 gm accumulative dose. Clinical skin lesions of histoplasmosis and good response to treatment are discussed.
Insights
Histoplasmosis, a fungal infection, can manifest with skin lesions, particularly in individuals with AIDS. Early diagnosis and treatment with amphotericin B led to successful outcomes in three male patients.
Area of Science:
- Mycology
- Infectious Diseases
- Dermatology
Background:
- Histoplasmosis is typically a pulmonary infection caused by Histoplasma capsulatum.
- Cutaneous manifestations occur in 10-17% of cases, with a higher prevalence noted in Mexico.
- Human Immunodeficiency Syndrome (AIDS) is a significant risk factor for disseminated histoplasmosis.
Observation:
- Three male patients diagnosed with AIDS presented with fever, lymphadenopathy, and weight loss.
- Clinical presentations included lingual ulcers and disseminated erythemato-violaceus plaques, papular, and fistular skin lesions.
- Histopathologic examination revealed granulomatous lesions consistent with fungal infection.
Findings:
- Histoplasma capsulatum was successfully isolated from cultures in all three cases.
- All patients received treatment with amphotericin B, achieving a cumulative dose of 1.5 gm.
- Successful resolution of clinical skin lesions and overall recovery were observed post-treatment.
Implications:
- This case series highlights the importance of recognizing mucocutaneous lesions in diagnosing disseminated histoplasmosis in AIDS patients.
- Prompt diagnosis and effective treatment with amphotericin B are crucial for managing severe cases of histoplasmosis.
- Further research into the epidemiology and clinical spectrum of histoplasmosis in immunocompromised populations is warranted.