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A Fatal Case of Disseminated Histoplasmosis by Histoplasma capsulatum var. capsulatum Misdiagnosed as Visceral Leishmaniasis-Molecular Diagnosis and Identification.
Calvopiña, Manuel; Toro, Marcelo; Bastidas-Caldes, Carlos; Vasco-Julio, David; Muñoz, Greta.
Afiliação
  • Calvopiña M; One Health Research Group, Universidad de Las Américas (UDLA), Quito 170124, Ecuador.
  • Toro M; Hospital Pediátrico "Baca Ortiz", Quito 170523, Ecuador.
  • Bastidas-Caldes C; One Health Research Group, Universidad de Las Américas (UDLA), Quito 170124, Ecuador.
  • Vasco-Julio D; Programa de Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico.
  • Muñoz G; Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca 62050, Mexico.
Pathogens ; 12(9)2023 Aug 30.
Article em En | MEDLINE | ID: mdl-37764920
Histoplasmosis is an endemic mycosis in the Americas. However, its diagnosis is challenging due to the complexity and limited availability of conventional laboratory techniques-antigen tests, culture, and staining. Microscopic preparations often confuse with other pathogens, such as Leishmania spp. The genus Histoplasma capsulatum comprises three varieties: var. capsulatum, var. duboissi, and var. farciminosum, which cannot be distinguished using conventional techniques. An infant from a tropical region of Ecuador was hospitalized for fever, bloody diarrhea, and anemia persisting for two months. Upon admission, he received antibiotics and immunosuppressants. Histopathological examination of the lymph nodes, intestines, and bone marrow aspirate reported the presence of Leishmania-like amastigotes, and treatment was initiated with meglumine antimoniate and conventional amphotericin B. However, subsequent analysis of samples using PCR and DNA sequencing identified H. capsulatum var. capsulatum but not Leishmania. Despite fluconazole and amphotericin B, the infant succumbed to the disease. The delay in clinical and laboratory diagnosis of histoplasmosis and the use of nonspecific and ineffective drugs such as fluconazole led to disease dissemination and, ultimately, death. Implementing molecular diagnosis and antigen tests in laboratories located in endemic regions and reference hospitals is crucial.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Prognostic_studies Idioma: En Revista: Pathogens Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Equador País de publicação: Suíça

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Diagnostic_studies / Prognostic_studies Idioma: En Revista: Pathogens Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Equador País de publicação: Suíça