An unusual presentation of disseminated histoplasmosis in a non-HIV patient from Vietnam / Histoplasmosis diseminada en un paciente no-VIH en Vietnam: una presentación poco frecuente

Background: Histoplasmosis is a systemic infection caused by the dimorphic fungus Histoplasma capsulatum, naturally found in nitrogen-rich soil, whose main transmission route is the inhalation of conidia. Up to 95% of histoplasmosis cases are asymptomatic or transient, and the remaining 5% of cases have pathological manifestations in the lungs, bone marrow, liver, spleen, intestine, mucous membranes, and rarely on the skin. This mycosis has been reported from many endemic areas, mainly in immunosuppressed patients, such as HIV-positive patients, and its disseminated form is rarely reported. Case report: Histoplama capsulatum was isolated and identified by means of microscopy, culture characteristics and nested PCR from the cutaneous lesions of a non-HIV patient from Vietnam. The patient improved significantly with systemic itraconazole treatment. Conclusions: Disseminated histoplasmosis with cutaneous involvement in non-HIV patients is an extremely unusual presentation

Antecedentes: La histoplasmosis es una infección sistémica causada por Histoplasma capsulatum, un hongo dimorfo que se encuentra naturalmente en suelos nitrogenados, y cuya principal vía de transmisión es a través de la inhalación de conidios. Hasta el 95% de las histoplasmosis son asintomáticas o transitorias, y el 5% restante de los casos presenta manifestaciones clínicas en pulmones, médula ósea, hígado, bazo, intestino, membranas mucosas y, raramente, en piel. Esta micosis ha sido reportada en muchas áreas endémicas, mayoritariamente en pacientes inmunodeprimidos, tales como los infectados por el VIH, y su forma diseminada es infrecuente. Caso clínico: Histoplasma capsulatum fue aislado e identificado en el examen microscópico, cultivo y PCR anidada de las lesiones cutáneas de un paciente no-VIH de Vietnam. El paciente mejoró significativamente con tratamiento sistémico con itraconazol. Conclusiones: La histoplasmosis diseminada con manifestación cutánea en pacientes no-VIH es una presentación extremadamente inusual

An unusual presentation of disseminated histoplasmosis in a non-HIV patient from Vietnam.

BACKGROUND: Histoplasmosis is a systemic infection caused by the dimorphic fungus Histoplasma capsulatum, naturally found in nitrogen-rich soil, whose main transmission route is the inhalation of conidia. Up to 95% of histoplasmosis cases are asymptomatic or transient, and the remaining 5% of cases have pathological manifestations in the lungs, bone marrow, liver, spleen, intestine, mucous membranes, and rarely on the skin. This mycosis has been reported from many endemic areas, mainly in immunosuppressed patients, such as HIV-positive patients, and its disseminated form is rarely reported. CASE REPORT: Histoplama capsulatum was isolated and identified by means of microscopy, culture characteristics and nested PCR from the cutaneous lesions of a non-HIV patient from Vietnam. The patient improved significantly with systemic itraconazole treatment. CONCLUSIONS: Disseminated histoplasmosis with cutaneous involvement in non-HIV patients is an extremely unusual presentation.