Reyes M, Arenas LR, Pichardo P, Vick R, Torres A, Zacarías R

Idioma: Español
Referencias bibliográficas: 23
Paginas: 270-275
Archivo PDF: 99.01 Kb.

RESUMEN

La histoplasmosis es una enfermedad esencialmente pulmonar causada por Histoplasma capsulatum var capsulatum. Las manifestaciones cutáneas se presentan en el 10 a 17% de casos y en México parecen ser más frecuentes. Se presentan tres pacientes del sexo masculino con diagnóstico de síndrome de inmunodeficiencia adquirida de 26, 33 y 44 años de edad. Presentaban fiebre, linfadenopatía y pérdida de peso. El primero con úlcera lingual, el segundo y tercero con placas eritemato-violáceas, pápulas y pústulas diseminadas. Las biopsias mostraron lesiones granulomatosas y en el cultivo se aisló H. capsulatum. Los tres pacientes fueron tratados con una dosis de anfotericina B acumulativa de 1.5 g con buena respuesta al tratamiento en general y remisión de las lesiones dermatológicas. Se discuten las manifestaciones cutáneas y la adecuada respuesta al tratamiento sistémico con anfotericina B.

REFERENCIAS (EN ESTE ARTÍCULO)

1. Vick R, Arenas R, López JJ, Parraguirre S, Castro G, Fabian G. Histoplasma capsulatum: un agente causal frecuente de micosis en SIDA en México. Dermatol Rev Mex 1996;40(6):417-419.

2. Bellman B, Berman B, Sasken H, Kirsner RS. Cutaneous disseminated histoplasmosis in AIDS patients in South Florida. lnt J Dermatol 1997;36:599-603.

3. Taylor ML, Pedroza-Seres M, Gamez-Aranda A, Toriello C. Retrospective serological study of histoplasmosis in Mexico. Mycoses 1993;36:25-30.

4. Bonifaz A, Cancela R, Novales J, Montes de Oca G, Navarrete G, Romo J. Cutaneous histoplasmosis associated with acquired immunodeficiency syndrome (AIDS). lnt J Dermatol 2000;39:30-0.

5. Conant MA. Fungal infections in AIDS and other immunocompromised patients. J Am Acad Dermatol 1994;31:547-550.

6. Cahn P, Belloso WH, Murillo J, Prada-Trujillo G. AIDS in Latin America. lnfecti Dis Clin North America 2000;14 (1):185-209.

7. Cole MC, Cohen PR, Satra KH, et al. The concurrent presence of systemic disease pathogen and cutaneous Kaposi’s sarcoma in the same lesion: Histoplasma capsulatum and Kaposi’s sarcoma coexisting in a single skin lesion in a patient with AIDS. J Am Acad Dermatol 1992;26:285-287.

8. Wheat U, Síama TG, Zeckel Ml. Histoplasmosis in the acquired immunodeficiency syndrome. Am J Med 1985;78:203-210.

9. Cohen PR, Grossman ME, Silvers DN. Disseminated histoplasmosis and human immunodeficiency virus infection. lnt J Dermatol 1991;130:614-622.

10. Orozco-Topete ML, Reyes E. Histoplasmosis cutánea en nueve pacientes con SIDA. Rev lnvest Clin 1998;50(6):52-58.

11. Rodríguez G, Ordoñez N, Motta A. Histoplasma capsulatum var. capsulatum within cutaneous nerves in patients with disseminated histoplasmosis and AIDS (letter). Br J Dermatol 2001;144:205-207.

12. Wheat U, Connolly PA, Baker RL, Curfman MF, Eads ME, Israel KS, et al. Disseminated histoplasmosis in the acquired immune deficiency syndrome: clinical findings, diagnosis and treatment, and review of the literature. Medicine 1990; 69(6):361-374.

13. Edelman M, Mckitrick J. Histoplasma capsulatum, in peripheral blood smear. N Engl J Med. 2000;342(1):28.

14. Morbidity and Mortality Weekly Report from the CDC: 2001;50:261-262

15. Wheat U, Chetchotisakd P, Williams B, Connolly P, Shutt K, Hajjeh R. Factors associated with severe manifestations of histoplasmosis in AlDS. Clin lnfect Dis 2000; 30:877-1.

16. Porras B, Costner M, Friedman-Kien AE, Cockerell CJ. Update on cutaneous manifestations of HIV infection. Med Clini North Am 1998;82(5):1033-1077.

17. Akpek G, Lee SM, Gagnon DR, Cooley TP, Wright DG. Bone marrow aspiration, biopsy and culture in the evaluation of HIV- infected patients for invasive Mycobacteria and Histoplasma infections. Am J Hematol 2001; 67:100-106.

18. Eidbo J, Sánchez RL, Tschen JA, et al. Cutaneous manifestation of histoplasmosis in the acquired immunodeficiency syndrome. Am J Surg Pathol 1993;17:110-116.

19. Welykyk S, Von Heimburg A, Massa MC, et al. Cutaneous lesions of histoplasmosis with transepidermal elimination in a patient with acquired immunodeficiency syndrome. Cutis 1991;47: 397-400.

20. Lindgren AM, Fallon JD, Horan RF. Psoriasiform papules in the acquired immunodeficiency syndrome: disseminated histoplasmosis in AIDS. Arch Dermatol 1991;127:722-.

21. Cohen PR, HeId JL, Grossman ME. Disseminated histoplasmosis presenting as an ulcerated verrucous plaque in a human immunodeficiency virus-infected man. Int J Dermatol 1991;130:104-108.

22. Gumbo T, Just-Nubling G, Robertson V, et al. Clinicopathological features of cutaneous histoplasmosis in human immunodeficiency virus-infected patients in Zimbabwe. Trans R Soc Trop Med Hyg 2001;95:635-636.

23. Wheat U, Sarosi G, McKinsey D, Hamill R, Bradsher R, Johnson P, Loyd R, Kauffman C. Practice guidelines for the management of patients with histoplasmosis. Clin lnfect Dis 2000;30:688-695.