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Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
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Passive Administration of Monoclonal Antibodies Against H. capsulatum and Others Fungal Pathogens
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Hepatic Histoplasmosis: An Update.

Maimuna Sayeed1, Md Benzamin1, Luthfun Nahar1

  • 1Department of Paediatric Gastroenterology & Nutrition, Bangabandhu Shiekh Mujib Medical University (BSMMU), Dhaka, Bangladesh.

Journal of Clinical and Translational Hepatology
|September 5, 2022
PubMed
Summary

Histoplasma capsulatum, a common endemic mycosis, can rarely present as isolated liver infection. Clinicians should consider this fungal infection in both immunocompetent and immunocompromised patients, even without lung symptoms.

Keywords:
Hepatic manifestationHistoplasma capsulatumHistoplasmosisMycosis

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Area of Science:

  • Mycology
  • Infectious Diseases
  • Hepatology

Background:

  • Histoplasma capsulatum is a prevalent cause of endemic mycosis globally.
  • While typically self-limited in immunocompetent individuals, it causes opportunistic infections in immunocompromised patients.
  • Disseminated histoplasmosis commonly involves the liver, but primary hepatobiliary infection is rare.

Purpose of the Study:

  • To highlight the rare presentation of Histoplasma capsulatum as an isolated hepatobiliary infection.
  • To emphasize the importance of considering histoplasmosis in hepatobiliary disease, irrespective of pulmonary involvement or immune status.
  • To alert clinicians to this diagnostic possibility in both endemic and non-endemic regions.

Main Methods:

  • Case review and literature synthesis.
  • Diagnostic evaluation of hepatobiliary abnormalities.
  • Clinical correlation of symptoms, immune status, and geographical exposure.

Main Results:

  • Isolated hepatic histoplasmosis without primary pulmonary involvement is an uncommon but recognized clinical entity.
  • The diagnosis requires careful evaluation, especially in patients with unexplained liver dysfunction.
  • Histoplasmosis should be considered across a spectrum of patients, including immunocompetent individuals.

Conclusions:

  • Clinicians must maintain a high index of suspicion for isolated hepatobiliary histoplasmosis.
  • Prompt and thorough diagnostic workup is crucial for timely identification and management.
  • Awareness of this presentation aids in appropriate patient care, regardless of endemicity or immune status.