title: Histoplasmosis presenting as cellulitis 18 years after renal transplantation.
abstract: A 49-year-old renal transplant patient, under an 18-year course of immunosuppressive therapy with prednisone and azathioprine and, more recently, prednisone plus mycophenolate sodium, developed a cutaneous-subcutaneous infection caused by Histoplasma capsulatum. The clinical presentation consisted of a slowly enlarging, erythematous and infiltrative 25 cm plaque in the major axis on the arm. There was no involvement of the lungs or any other organ. Cure was obtained with itraconazole treatment after 12 months. Histoplasmosis is an uncommon opportunistic infection among solid organ transplanted patients with incidence of 0% to 2.1% observed in a large number of cases. This report describes an atypical cutaneous clinical presentation of a potentially fatal disease in immunosuppressed patients.
authors.affiliation: Department of Dermatology and Radiotherapy, Botucatu School of Medicine, Sao Paulo State University, Brazil. smarques@fmb.unesp.br
authors.forename: Silvio A
authors.initials: SA
authors.lastname: Marques
authors.forename: Silvia
authors.initials: S
authors.lastname: Hozumi
authors.forename: Rosangela M P
authors.initials: RM
authors.lastname: Camargo
authors.forename: Maria Fernanda C
authors.initials: MF
authors.lastname: Carvalho
authors.forename: Mariangela E A
authors.initials: ME
authors.lastname: Marques
mesh_terms: D002481:Cellulitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D005260:Female; D006658:Histoplasma / Q000302:isolation & purification*; D006660:Histoplasmosis / Q000150:complications* / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D016867:Immunocompromised Host; D017964:Itraconazole / Q000627:therapeutic use; D016030:Kidney Transplantation; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D017964:Itraconazole