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Mucocutaneous Manifestations of Infection by Histoplasma capsulatum in HIV-Negative Immunosuppressed Patients
L V Gómez-Santana1, A C Torre1, B A Hernández1
1Servicio de Dermatología, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
Abstract:
Histoplasmosis is a systemic mycosis caused by the dimorphous fungus Histoplasma capsulatum (H. capsulatum). The fungus enters the body through the respiratory tract in the form of microconidia, which are transformed into intracellular yeast-like structures in the lungs before disseminating hematogenously. Primary infection is usually asymptomatic and self-resolving. Some patients develop severe disease with acute or chronic respiratory involvement. Immunosuppressed patients, mainly those with altered cellular immunity, may have disseminated disease with variable mucocutaneous involvement characterized by papules, nodules, gummas, or ulcers with a granulomatous base. We report the case of 3 HIV-negative patients infected by H capsulatum in whom diagnosis based on the skin lesions proved essential for early initiation of treatment.
Insights
Histoplasmosis, a fungal infection, can cause severe respiratory or disseminated disease. Diagnosing Histoplasma capsulatum via skin lesions in HIV-negative patients is crucial for timely treatment.
Area of Science:
- Mycology
- Infectious Diseases
- Dermatology
Background:
- Histoplasmosis is a systemic mycosis caused by Histoplasma capsulatum.
- Infection typically occurs via respiratory inhalation of microconidia.
- Primary infection is often asymptomatic, but severe respiratory or disseminated forms can develop.
Observation:
- Disseminated histoplasmosis can manifest with mucocutaneous lesions in immunocompromised individuals.
- This report details three HIV-negative patients with Histoplasma capsulatum infection.
- Diagnosis was significantly aided by the presence of characteristic skin lesions.
Findings:
- Skin manifestations were key to identifying Histoplasma capsulatum infection.
- Early diagnosis through cutaneous lesions facilitated prompt treatment initiation.
- The study highlights the diagnostic importance of mucocutaneous findings in non-HIV-associated histoplasmosis.
Implications:
- Recognizing skin lesions as diagnostic markers can improve histoplasmosis management.
- This approach is particularly relevant for HIV-negative patients presenting with disseminated disease.
- Early diagnosis and treatment of histoplasmosis can prevent severe complications.
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