Progressive disseminated histoplasmosis in an immunocompetent patient as an underrecognized imported mycosis in Japan |
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| Authors: | Goh Ohji Ken Kikuchi Keiichi Inoue Kazuya Imoto Shungo Yamamoto Naoto Hosokawa Katsuhiko Kamei Kentaro Iwata |
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| Institution: | (1) Division of Infectious Disease Therapeutics, Department of Microbiology and Infectious Diseases, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe Hyogo, 650-0017, Japan;(2) Medical Risk Management, Research Center for Urban Safety and Security, Kobe University, Hyogo, Japan;(3) Department of Infection Control Science, Faculty of Medicine, Juntendo University, Tokyo, Japan;(4) Department of Pulmonary Medicine, Kameda Medical Center, Kamogawa, Japan;(5) Department of General Medicine and Infectious Diseases, Kameda Medical Center, Kamogawa, Japan;(6) Department of Pathogenic Fungi, Research Center for Pathogenic Fungi and Microbial Toxicoses, Chiba University, Chiba, Japan |
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| Abstract: | Histoplasmosis caused by Histoplasma capsulatum is found worldwide. Japan is known to be non-endemic area. Progressive disseminated histoplasmosis (PDH) is a severe form
of histoplasmosis. We report a case of PDH in a 54-year-old male who was not immunocompromised. His last travel history to
an endemic region was 2 years before onset. He was diagnosed as histoplasmosis by 18S rRNA-PCR from serum and ascites and
immunodiffusion test. We treated him with parental liposomal amphotericin B for 2 weeks then changed to oral itraconazole,
which was continued for 6 months. Rigorous work up, including HIV status, lymphocyte counts, and adrenal function did not
reveal any evidence of immunosuppression of the patient. Our case suggests that PDH can occur in immunocompetent patients
as previously described, and must be included in the differential diagnoses if presentation is consistent. In addition, the
skills of travel history taking are emphasized. |
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| Keywords: | Disseminated histoplasmosis Immunocompetence |
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