Leiva M, Cubilla E, Guzmán A, Mendoza G, Aguilar FG

Language: Spanish
References: 10
Page: 28-32
PDF size: 201.76 Kb.

ABSTRACT

Histoplasmosis is a worldwide systemic fungal infection, caused by a dimorphic fungus Histoplasma capsulatum var. capsulatum, and in Africa, by H. duboisii. The most frequent clinical forms are pulmonary and disseminated, the latter is common in patients with AIDS, affecting cutaneous or mucous membranes with pustules, papules, molluscoid, psoriasiform or vegetating plaques, and erythema nodosum or multiform-like plaques. We report a 49 year old male patient with AIDS with a 30 day history of diarrhea, fever and disseminated papules, nodules and erythematous lesions. Diagnosis of disseminated histoplasmosis was done by serology and culture, and he was treated with amphotericin B, 1 mg/kg for 1 month, with a good response.
Later on he was treated with itraconazole for several months, and after 18 months he is in complete remission.

REFERENCES

1. Arenas R. Histoplasmosis. Atlas Diagnóstico y Tratamiento. 4a Ed., México, McGraw-Hill, 2009: 190-198.

2. Acuña S, Sehtman A, Donatti L, et al. “Histoplasmosis Diseminada Crónica”. Act Terap Dermatol 2008; 31(1): 38-42.

3. Ramdial PK, Mosam A, Dlova NC, Satar NB, Aboobaker J, Singh SM. “Disseminated Cutaneus H with human inmunodeficiency virus”. J Cutan Pathol 2002; 29: 215-225.

4. Sánchez Alemán MA. “Histoplasmosis, la micosis del viajero”. Enf Inf Microbiol 2009; 28(3): 111-116.

5. Peching G, Kuno Kawa Z, Galarza C. “Histoplasmosis Diseminada Aguda: Enfoque de manifestaciones Cutáneas”. Folia Dermatol (Perú) 2004; 15(3): 172-175.

6. Pietrobon D, Negro L, Kiltein J, Galindez J, Greca A, Battagliotti C. “Histoplasmosis diseminada y SIDA en un hospital argentino: manifestaciones clínicas, diagnóstico y tratamiento”. Enferm Infecc Microbiol Clín 2004; 22(3): 156-159.

7. Luther JM, Lakey DL, Larson RS, Kallian Pur Ar, Dagata E, Cousar JB, et al. “Utility of bone marrow biops y for rapid diagnosis of febrile illnesses in patients with with human inmuno deficiencyvirus infection”. South med J 2000; 93(7): 692-697.

8. Díaz García M, León Mora C, Waleska M, Hernández D. “Histoplasmosis Diseminada Progresiva y Tuberculosis en pacientes con Sida”. Medicina Interna 2004; 20(4): 187-210.

9. Fernandez-Martinez RF, Arenas R. “Síndrome inflamatorio de reconstitución inmune (SIRI). Una revisión para entenderlo.” Med Cutan Iber Lat Am 2008; 36(3): 113-119.

10. Fernández Bussy R, Gatti CF, Porta Guardia C. “Infecciones de transmisión sexual y SIDA: Síndrome de restauración autoinmune”. En: Fernández Bussy R, Fundamentos en Dermatología clínica. 1a Ed., Buenos Aires, Journal, 2011: 182.