Progressive Severe Hemophagocytic Syndrome due to disseminated Histoplasmosis in a Patient with HIV-1 Infection.

Autor: Yamasaki L; Center Hospital of the National Center for Global Health and Medicine, Japan.; Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Japan.; AIDS Clinical Center, National Center for Global Health and Medicine, Japan., Akiyama Y; AIDS Clinical Center, National Center for Global Health and Medicine, Japan.; Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan., Ueno K; Department of Fungal Infection, National Institute of Infectious Diseases, Japan., Hoshino Y; Department of Fungal Infection, National Institute of Infectious Diseases, Japan., Nagi M; Department of Fungal Infection, National Institute of Infectious Diseases, Japan., Nakayama N; Department of Fungal Infection, National Institute of Infectious Diseases, Japan., Abe M; Department of Fungal Infection, National Institute of Infectious Diseases, Japan., Miyazaki Y; Department of Fungal Infection, National Institute of Infectious Diseases, Japan., Gatanaga H; AIDS Clinical Center, National Center for Global Health and Medicine, Japan.; The Joint Research Center for Human Retrovirus Infection, Kumamoto University Campus, Kumamoto City, Japan., Watanabe K; AIDS Clinical Center, National Center for Global Health and Medicine, Japan.; Division of Host Defense Mechanism, Tokai University School of Medicine, Japan.
Jazyk: angličtina
Zdroj: Internal medicine (Tokyo, Japan) [Intern Med] 2024 Sep 04. Date of Electronic Publication: 2024 Sep 04.
DOI: 10.2169/internalmedicine.4079-24
Abstrakt: Histoplasmosis is caused by Histoplasma capsulatum and is prevalent in areas of the world where H. capsulatum is endemic. We herein report a patient diagnosed with HIV-1 who developed histoplasmosis from a non-H. capsulatum endemic area who experienced severe hemophagocytic syndrome due to a delayed diagnosis. The patient's symptoms emerged four years after residing in regions with a high histoplasmosis prevalence. The unrestricted administration of antifungal medication for oral candidiasis delayed the diagnosis because it improved the patient's condition. This case underscores the importance of prudent antifungal drug use in undiagnosed disseminated conditions and evaluating the travel history going back several years to facilitate a diagnosis.
Databáze: MEDLINE