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[Disseminated histoplasmosis].

María I de José Gómez1, M Orio Hernández, A Bilbao Garagoitia

  • 1Servicio de Pediatría-Infecciosos, Hospital La Paz, Madrid, Spain. ijose.hulp@salud.madrid.org

Anales De Pediatria (Barcelona, Spain : 2003)
|October 13, 2005
PubMed
Summary

Disseminated histoplasmosis is a severe fungal infection. Early diagnosis and treatment are crucial in immunocompromised children from endemic areas, even without chest X-ray findings.

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Area of Science:

  • Infectious Diseases
  • Mycology
  • Pediatrics

Background:

  • Disseminated histoplasmosis is a severe systemic fungal infection caused by Histoplasma capsulatum.
  • It disproportionately affects immunocompromised individuals, particularly those from or who have traveled to endemic regions like Latin America.

Observation:

  • Two cases of disseminated histoplasmosis in immunocompromised pediatric immigrants from Latin America are presented.
  • Both patients exhibited prolonged fever, weight loss, hepatosplenomegaly, and pancytopenia.
  • One patient presented with respiratory symptoms and radiographic abnormalities, while the other did not.

Findings:

  • Despite broad-spectrum antibiotic treatment and diagnostic sampling, both cases resulted in rapid, fatal outcomes.
  • Diagnosis was confirmed post mortem in both children.

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  • The severity and infrequency of the infection in the local environment highlight diagnostic challenges.

    • Implications:

    • Disseminated histoplasmosis should be strongly considered in the differential diagnosis of febrile illnesses with hepatosplenomegaly and pancytopenia in at-risk pediatric populations.
    • Prompt initiation of antifungal therapy is critical, even before definitive diagnostic test results are available, due to the aggressive nature of the disease.
    • Increased awareness and consideration of this fungal infection are necessary for timely intervention in immunocompromised children with relevant travel or geographic exposure.