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Disseminated histoplasmosis in acquired immunodeficiency syndrome: light and electron microscopic observations
1Department of Pathology and Oncology, University of Kansas Medical Center, KS 66103.
Abstract:
Two young homosexual men with acquired immunodeficiency syndrome (AIDS) presented with five-lobe pneumonia and maculopapular rash, respectively, and were found to have disseminated histoplasmosis by examination of peripheral blood smears. Bone marrow smears from one patient revealed more numerous Histoplasma capsulatum organisms than peripheral blood smears did. Electron microscopy of peripheral-blood buffy coat demonstrated histoplasma organisms in monocytes and neutrophils as well as tubuloreticular structures in small lymphocytes. A search for Histoplasma capsulatum in peripheral blood smears from patients with AIDS is warranted, especially in endemic midwestern states.
Insights
Disseminated histoplasmosis was diagnosed in two men with acquired immunodeficiency syndrome (AIDS) via blood smear analysis. Early detection of Histoplasma capsulatum in peripheral blood is crucial for AIDS patients, particularly in the Midwest.
Area of Science:
- Mycology
- Infectious Diseases
- Immunology
Background:
- Acquired immunodeficiency syndrome (AIDS) compromises immune function, increasing susceptibility to opportunistic infections.
- Disseminated infections pose a significant threat to individuals with advanced HIV/AIDS.
- Histoplasmosis is a fungal infection caused by Histoplasma capsulatum, endemic in certain regions.
Purpose of the Study:
- To report the diagnosis of disseminated histoplasmosis in two homosexual men with AIDS.
- To highlight the utility of peripheral blood smear examination for detecting Histoplasma capsulatum in AIDS patients.
- To investigate the presence of Histoplasma organisms within specific blood cell types.
Main Methods:
- Peripheral blood smears were examined for the presence of Histoplasma capsulatum.
- Bone marrow smears were analyzed for comparison with peripheral blood findings.
- Electron microscopy was employed to visualize Histoplasma organisms within monocytes and neutrophils and to identify viral-associated structures in lymphocytes.
Main Results:
- Disseminated histoplasmosis was confirmed in both patients through peripheral blood smear examination.
- Bone marrow smears showed a higher organism burden than peripheral blood smears in one patient.
- Electron microscopy confirmed Histoplasma organisms within monocytes and neutrophils and revealed tubuloreticular structures in lymphocytes.
Conclusions:
- Peripheral blood smear examination is a valuable diagnostic tool for disseminated histoplasmosis in patients with AIDS.
- Early detection of Histoplasma capsulatum in peripheral blood is recommended for AIDS patients, especially in endemic areas like the Midwestern United States.
- The findings underscore the importance of considering fungal infections in the differential diagnosis of febrile illnesses in immunocompromised individuals.