title: Histoplasmosis as cause of penile ulcer in acquired immune deficiency syndrome (AIDS): three case reports.
abstract: BACKGROUND
  Histoplasma capsulatum is the causative agent of American histoplasmosis. The relationship between disseminated histoplasmosis and AIDS has been well established. Widespread hematogenous dissemination of Histoplasma capsulatum in HIV positive patients can cause a plethora of clinical manifestations; virtually any organic system can be affected. However, genital ulceration by H. capsulatum in patients with AIDS is a real challenge during investigation of the infection due to the great variety of differential diagnoses that are involved.
  
  
  METHODS
  The diagnosis was performed by histopathologic study; H. capsulatum was detected by silver staining (Grocott staining) and confirmed by immunocytochemistry.
  
  
  RESULTS
  We report three cases of histoplasmosis in patients with AIDS, in which we observed genital ulcers, an unusual form of presentation of this disease. In one of these cases, the treatment resulted in total cure.
  
  
  CONCLUSIONS
  The cases reported herein are to illustrate the plurality of pathologies and clinical manifestations, which may affect immunocompromised patients. The correct diagnosis of fungal diseases in these patients following well established treatment will improve the prognosis.
authors.affiliation: Medical School in São José do Rio Preto, Hospital de Base, Avenida Brigadeiro Faria Lima, n. 5416, CEP 15090-000, Sao Jose do Rio Preto, SP, Brazil.
authors.forename: Ederson Valei Lopes
authors.initials: EV
authors.lastname: de Oliveira
authors.forename: Fernanda Belluci
authors.initials: FB
authors.lastname: Miduati
authors.forename: João Roberto
authors.initials: JR
authors.lastname: Antonio
authors.forename: Rafael
authors.initials: R
authors.lastname: de Negreiros Moraes
authors.forename: Margarete Teresa Gottardo
authors.initials: MT
authors.lastname: de Almeida
authors.forename: Solange Corrêa Garcia Pires
authors.initials: SC
authors.lastname: D'Avilla
authors.forename: Eurides Maria
authors.initials: EM
authors.lastname: de Oliveira Pozetti
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology* / Q000473:pathology; D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use; D017809:Fatal Outcome; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology / Q000821:virology; D006801:Humans; D008297:Male; D010409:Penile Diseases / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology / Q000821:virology; D012883:Skin Ulcer / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology / Q000821:virology
chemical_list: D000935:Antifungal Agents