Mucocutaneous Manifestations of Infection by Histoplasma capsulatum in HIV-Negative Immunosuppressed Patients

Actas Dermosifiliogr (Engl Ed). 2018 May;109(4):e27-e32. doi: 10.1016/j.ad.2017.08.006. Epub 2018 Feb 9.
[Article in English, Spanish]

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.

Keywords: Cutaneous histoplasmosis; Disseminated histoplasmosis; Histoplasmosis cutánea; Histoplasmosis diseminada; Immunosuppression; Inmunosupresión; Itraconazol; Itraconazole.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Early Diagnosis
  • Facial Dermatoses / diagnosis*
  • Facial Dermatoses / etiology
  • HIV Seronegativity
  • Heart Transplantation
  • Histoplasma / isolation & purification
  • Histoplasmosis / diagnosis*
  • Histoplasmosis / immunology
  • Histoplasmosis / microbiology
  • Humans
  • Immunocompromised Host
  • Liver Transplantation
  • Male
  • Middle Aged
  • Oral Ulcer / etiology
  • Postoperative Complications / diagnosis