[Manifestations of histoplasmosis].
Two patients, a 34-year old man-to-woman transsexual and a 32-year-old man, with aids presented with pulmonary symptoms, fever, serious weight loss and an oral ulcer. A third patient, a 16-year-old boy, had signs of transverse myelitis and meningitis without immunodeficiency. All were South American citizens and had disseminated histoplasmosis. After antifungal treatment they recovered, although the third patient remained a wheelchair user. If pulmonary or miliary tuberculosis is suspected in a patient originating from South America, histoplasmosis should be considered. Oral ulcers and skin lesions can be diagnostic clues. Specific stainings of direct preparations and longer-lasting cultures of various materials, especially of biopsy samples, then provide the diagnosis.
Claessen
F A
FA
Afd. Inwendige geneeskunde, Academisch Ziekenhuis Vrije Universiteit, Amsterdam.
Vos
M J
MJ
Simoons-Smit
A M
AM
Debets-Ossenkopp
Y J
YJ
Perenboom
R M
RM
D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D006660:Histoplasmosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000208:ethnology; D006801:Humans; D008297:Male; D008581:Meningitis / Q000382:microbiology; D009188:Myelitis, Transverse / Q000382:microbiology; D011014:Pneumonia / Q000382:microbiology; D013020:South America / Q000208:ethnology; D013281:Stomatitis, Aphthous / Q000382:microbiology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis
D000935:Antifungal Agents