Syn.: Histoplasmosis, histoplasmosis capsulati, american histoplasmosis, choroba Darlinga.
Def .: Mycosis of the reticuloendothelial system of humans and animals.
Epid .: The disease occurs in Ohio and the Mississippi River Valley, the area of occurrence coincides with the site of blastomycosis. It is also found locally in South America, Asia, Australia and Africa.
Etiol.: Histoplasma capsulatum var. encapsulated
Pat .: This fungus enters the human body by inhalation. Primary infection usually occurs in childhood. The source of infection is soil contaminated with the faeces of bats, chickens and other birds.
Lok .: From the lungs, the fungus enters the bloodstream, settles in various organs. It can be detected in the cells of the reticuloendothelial system of the lungs and kidneys, in the liver and spleen.
Clinical: Lung infection often goes unnoticed. However, pneumonia may occur along with erythema nodosum. The most serious form is disseminated histoplasmosis. It is characterized by lymphadenopathy, hepatosplenomegaly, bone marrow suppression, fever and rapid weight loss. Disseminated histoplasmosis occurs in young children and immunocompromised people, and is often fatal. Skin symptoms in the acute stage of infection are erythema nodosum or erythema multiforme. In the chronic disseminated form of the disease, ulcers of the mucosa of the cheeks and palate, tongue, mouth, throat and upper gastrointestinal tract may occur. The skin may develop lumps or erythematous nodules, ulcerations, and subcutaneous tissue inflammation.
Hist .: Inflammation with granulomatous reaction in the dermis. The fungal cells are small and located inside macrophages. The specimen should be stained with the PAS method or with silver.
DL: Culture is a very infectious material, despite the slow growth of the fungus. Material from skin, mucosa and bone marrow can be sown. Fungus antigens can also be detected in the serum. The histoplasmine test has limited utility.
Healing: Ketoconazole or itraconazole. In acute disseminated form or with CNS involvement, amphotericin B should be used.
Year: Disseminated prognosis is poor.
Lit.: [1] Epifanio R.N., Brannon R.B., Muzyka B.C.: Disseminated histoplasmosis with oral manifestation. Spec CareDentist 2007, 27(6); 236-9. [2] Nosanchuk J.D., Gacser A.:Histoplasma capsulatum at the host pathogen interface. Microbes Infect 2008, 10(9); 973-7. [3] Shimamoto A., Takao M., Shomura S. i wsp.: Pulmonary histoplasmosis as an example of imported mycoses in Japan. Gen Th orac Cardiovasc Surg 2007, 55(8); 335-8. [4] Singhi M.K., Gupta L., Kacchawa D. i wsp.: Disseminated primary cutaneous histoplasmosis successfully treated with itraconazole. Indian J Dermatol Venereol Leprol 2003, 69(6); 405-7.
Source: A. Kaszuba, Z. Adamski: “Lexicon of dermatology”; XNUMXst edition, Czelej Publishing House