https://meditropics.com/answers/
Nikita Agarwal*
*Senior Resident, Department of Medicine, Lady Hardinge Medical College
- A) Generalized nodule-ulcerative lesions characteristic of chronic progressive disseminated histoplasmosis.
- B) On the right arm, there are multiple skin-colored umbilicated papules, hemorrhagic crusts, and ulcerated nodules.
- C) CT of the mediastinum showing pre-tracheal and hilar calcified lymph nodes.
- D) Photomicrograph of the pathologic specimen stained with periodic acid-Schiff shows numerous histiocytes and extracellular yeasts of H. capsulatum (magnification, +400).
Chronic Progressive Disseminated Histoplasmosis (CPDH)
Chronic progressive disseminated histoplasmosis (CPDH) is a rare manifestation of histoplasmosis, a fungal infection caused by Histoplasma capsulatum. CPDH usually affects immunocompromised patients, such as those with HIV/AIDS, but can also occur in immunocompetent individuals. CPDH is characterized by chronic fever, weight loss, anemia, hepatosplenomegaly, lymphadenopathy and skin lesions². CPDH can involve various organs, such as the lungs, liver, spleen, bone marrow, central nervous system and heart.
Histoplasmosis is endemic in some parts of the world, such as North America, Central and South America and Africa. In India, histoplasmosis is more common in the eastern regions along the riverbanks of Ganga and Brahmaputra, but sporadic cases have been reported from other parts of the country as well. Diagnosis of histoplasmosis is based on clinical features, laboratory tests and histopathological examination of tissue samples. Treatment of CPDH usually requires prolonged antifungal therapy with drugs such as amphotericin B or itraconazole.
References–
(1) Histoplasmosis: Epidemiology, Diagnosis, and Clinical Manifestations-https://link.springer.com/article/10.1007/s12281-019-00341-x
(2) Case Report: Histoplasmosis in Himachal Pradesh (India): An Emerging –https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805064/
(3) Progressive disseminated histoplasmosis in idiopathic CD4 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176308/
(4) Chronic Disseminated Histoplasmosis Bone Marrow Involvement in an –https://link.springer.com/article/10.1007/s12288-010-00226
(5) Chronic Progressive Disseminated Histoplasmosis in an Immunocompetent –