Presentations of chronic cavitary pulmonary histoplasmosis mimic infected cystic bronchiectasis in an immunocompetent host: A case report

Background: Chronic cavitary pulmonary disease and laryngeal involvement are unusual manifestations of Histoplasmosis capsulatum infection, particularly in patients who are not immunocompromised. The presence of fibro-cavitary lesions has been reported as a radiologic presentation of chronic histopl...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Worawat Chumpangern, Apichart So-Ngern, Wipa Reechaipichitkul, Atibordee Meesing, Pailin Ratanawatkul, Itthiphat Arunsurat, Nipon Chaisuriya
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Histoplasmosis Cavitary lung disease Laryngeal histoplasmosis Fungal infection Case report Diseases of the respiratory system RC705-779
Acceso en línea:	https://doaj.org/article/6d2fb5b75cc7458aa53852a739a63dd6
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:6d2fb5b75cc7458aa53852a739a63dd6
record_format	dspace
spelling	oai:doaj.org-article:6d2fb5b75cc7458aa53852a739a63dd62021-11-16T04:10:26ZPresentations of chronic cavitary pulmonary histoplasmosis mimic infected cystic bronchiectasis in an immunocompetent host: A case report2213-007110.1016/j.rmcr.2021.101555https://doaj.org/article/6d2fb5b75cc7458aa53852a739a63dd62021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2213007121002173https://doaj.org/toc/2213-0071Background: Chronic cavitary pulmonary disease and laryngeal involvement are unusual manifestations of Histoplasmosis capsulatum infection, particularly in patients who are not immunocompromised. The presence of fibro-cavitary lesions has been reported as a radiologic presentation of chronic histoplasmosis in patients with pre-existing lung disease. However, there have been few reports of extensive basal predominant cavitary lesions that mimic cystic-bronchiectasis. Case presentation: A 65-year-old previously healthy Thai male presented with productive cough, hoarseness, low-grade fever, and weight loss for 6 months. There was no history of significant exposure to Histoplasmosis capsulatum. Tests for HIV and anti–IFN–γ antibody were negative. Chest CT revealed multifocal thick wall cavities, which were distributed in a peri-bronchial pattern, and some areas of consolidation in both basal lungs. Laryngoscopy revealed an ulcerative lesion of the false vocal cords. Histopathological study of false vocal cords and lung tissue showed granulomatous inflammation with mixed inflammatory cell infiltration and aggregation of histiocytes containing round intracytoplasmic organisms. GMS-staining was positive, but negative mucicarmine-staining was negative. A real-time PCR assay of the lung tissue was positive for Histoplasmosis capsulatum. The final diagnosis was chronic cavitary pulmonary histoplasmosis with laryngeal involvement. Conclusion: Chronic cavitary pulmonary histoplasmosis is rare, as is laryngeal involvement. However, there have been such cases in endemic areas, even in immunocompetent patients. Chronic histoplasmosis should be considered in patients who present with the extensive basal predominant cavitary-pulmonary lesions that mimic cystic bronchiectasis.Worawat ChumpangernApichart So-NgernWipa ReechaipichitkulAtibordee MeesingPailin RatanawatkulItthiphat ArunsuratNipon ChaisuriyaElsevierarticleHistoplasmosisCavitary lung diseaseLaryngeal histoplasmosisFungal infectionCase reportDiseases of the respiratory systemRC705-779ENRespiratory Medicine Case Reports, Vol 34, Iss , Pp 101555- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Histoplasmosis Cavitary lung disease Laryngeal histoplasmosis Fungal infection Case report Diseases of the respiratory system RC705-779
spellingShingle	Histoplasmosis Cavitary lung disease Laryngeal histoplasmosis Fungal infection Case report Diseases of the respiratory system RC705-779 Worawat Chumpangern Apichart So-Ngern Wipa Reechaipichitkul Atibordee Meesing Pailin Ratanawatkul Itthiphat Arunsurat Nipon Chaisuriya Presentations of chronic cavitary pulmonary histoplasmosis mimic infected cystic bronchiectasis in an immunocompetent host: A case report
description	Background: Chronic cavitary pulmonary disease and laryngeal involvement are unusual manifestations of Histoplasmosis capsulatum infection, particularly in patients who are not immunocompromised. The presence of fibro-cavitary lesions has been reported as a radiologic presentation of chronic histoplasmosis in patients with pre-existing lung disease. However, there have been few reports of extensive basal predominant cavitary lesions that mimic cystic-bronchiectasis. Case presentation: A 65-year-old previously healthy Thai male presented with productive cough, hoarseness, low-grade fever, and weight loss for 6 months. There was no history of significant exposure to Histoplasmosis capsulatum. Tests for HIV and anti–IFN–γ antibody were negative. Chest CT revealed multifocal thick wall cavities, which were distributed in a peri-bronchial pattern, and some areas of consolidation in both basal lungs. Laryngoscopy revealed an ulcerative lesion of the false vocal cords. Histopathological study of false vocal cords and lung tissue showed granulomatous inflammation with mixed inflammatory cell infiltration and aggregation of histiocytes containing round intracytoplasmic organisms. GMS-staining was positive, but negative mucicarmine-staining was negative. A real-time PCR assay of the lung tissue was positive for Histoplasmosis capsulatum. The final diagnosis was chronic cavitary pulmonary histoplasmosis with laryngeal involvement. Conclusion: Chronic cavitary pulmonary histoplasmosis is rare, as is laryngeal involvement. However, there have been such cases in endemic areas, even in immunocompetent patients. Chronic histoplasmosis should be considered in patients who present with the extensive basal predominant cavitary-pulmonary lesions that mimic cystic bronchiectasis.
format	article
author	Worawat Chumpangern Apichart So-Ngern Wipa Reechaipichitkul Atibordee Meesing Pailin Ratanawatkul Itthiphat Arunsurat Nipon Chaisuriya
author_facet	Worawat Chumpangern Apichart So-Ngern Wipa Reechaipichitkul Atibordee Meesing Pailin Ratanawatkul Itthiphat Arunsurat Nipon Chaisuriya
author_sort	Worawat Chumpangern
title	Presentations of chronic cavitary pulmonary histoplasmosis mimic infected cystic bronchiectasis in an immunocompetent host: A case report
title_short	Presentations of chronic cavitary pulmonary histoplasmosis mimic infected cystic bronchiectasis in an immunocompetent host: A case report
title_full	Presentations of chronic cavitary pulmonary histoplasmosis mimic infected cystic bronchiectasis in an immunocompetent host: A case report
title_fullStr	Presentations of chronic cavitary pulmonary histoplasmosis mimic infected cystic bronchiectasis in an immunocompetent host: A case report
title_full_unstemmed	Presentations of chronic cavitary pulmonary histoplasmosis mimic infected cystic bronchiectasis in an immunocompetent host: A case report
title_sort	presentations of chronic cavitary pulmonary histoplasmosis mimic infected cystic bronchiectasis in an immunocompetent host: a case report
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/6d2fb5b75cc7458aa53852a739a63dd6
work_keys_str_mv	AT worawatchumpangern presentationsofchroniccavitarypulmonaryhistoplasmosismimicinfectedcysticbronchiectasisinanimmunocompetenthostacasereport AT apichartsongern presentationsofchroniccavitarypulmonaryhistoplasmosismimicinfectedcysticbronchiectasisinanimmunocompetenthostacasereport AT wipareechaipichitkul presentationsofchroniccavitarypulmonaryhistoplasmosismimicinfectedcysticbronchiectasisinanimmunocompetenthostacasereport AT atibordeemeesing presentationsofchroniccavitarypulmonaryhistoplasmosismimicinfectedcysticbronchiectasisinanimmunocompetenthostacasereport AT pailinratanawatkul presentationsofchroniccavitarypulmonaryhistoplasmosismimicinfectedcysticbronchiectasisinanimmunocompetenthostacasereport AT itthiphatarunsurat presentationsofchroniccavitarypulmonaryhistoplasmosismimicinfectedcysticbronchiectasisinanimmunocompetenthostacasereport AT niponchaisuriya presentationsofchroniccavitarypulmonaryhistoplasmosismimicinfectedcysticbronchiectasisinanimmunocompetenthostacasereport
_version_	1718426729173745664

Presentations of chronic cavitary pulmonary histoplasmosis mimic infected cystic bronchiectasis in an immunocompetent host: A case report

Ejemplares similares