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[Histoplasmosis - an unusual African souvenir]
C Raselli1, W H Reinhart, F Fleisch
1Departement für Innere Medizin, Kantonsspital Graubünden, Chur, Schweiz. craselli@gmx.net
Deutsche Medizinische Wochenschrift (1946)
|February 9, 2013
Summary
A severe case of histoplasmosis in an immunocompetent individual highlights the importance of considering fungal infections after travel to endemic areas. Prompt diagnosis and treatment with itraconazole led to full recovery.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Pulmonology
Background:
- A biology student developed severe respiratory illness after a trip to Uganda, initially treated for malaria and atypical pneumonia without success.
- Clinical presentation included fever, headache, dyspnea, and bilateral miliary infiltrates on chest X-ray.
Observation:
- Elevated inflammatory markers (CRP, liver enzymes, LDH) and impaired lung diffusion capacity were noted.
- Diagnostic workup was expedited by informal medical data exchange, revealing a potential bat exposure in a cave.
- Serological testing confirmed antibodies against Histoplasma capsulatum.
Findings:
- Treatment with itraconazole resulted in gradual improvement of clinical symptoms.
- Chest X-ray and lung function normalized after an 8-week course of antifungal therapy.
Implications:
- Severe histoplasmosis is uncommon in immunocompetent hosts, suggesting a high-dose exposure to Histoplasma capsulatum.
- Bat guano-contaminated soil is a known reservoir for Histoplasma.
- Leveraging electronic communication facilitated a rapid diagnosis and management of this rare fungal infection.
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