MyMedR

Wahab NA, Mohd R, Zainudin S, Kamaruddin NA

EXCLI J, 2013;12:1-4.

Histoplasmosis infection is endemic in Asia and disseminated histoplasmosis (DH) is one form of its presentation (Benevides et al., 2007[1]). DH commonly affects both adrenal glands. We describe a case of disseminated histoplasmosis complicated with hypercalcaemia in a 75-year-old immunosuppressed patient who presented with bilateral adrenal masses. The fine needle aspiration cytology of the adrenal mass was positive for Histoplasma capsulatum.

Matched MeSH terms: Histoplasmosis

Fulltext Histoplasmosis with Addisonian crisis: call for bird control

Hu AS, Hu AS, Hu CH

Med J Malaysia, 2015 Apr;70(2):104-5.

PMID: 26162388 MyJurnal

We report a case of disseminated histoplasmosis, initially diagnosed from gut nodule colonoscopically, along with evidence of lung disease. Subsequently he developed Addisonian crisis due to adrenal involvement. Lessons were learnt from the importance of detailed history-personal and social/family, as well as psychosocial aspects of illness. Public health measures to reduce bird dropping (and thus possibility of histoplasmosis) are discussed.

Matched MeSH terms: Histoplasmosis

Fulltext Laryngeal histoplasmosis: an occupational hazard

Teoh JW, Hassan F, Mohamad Yunus MR

Singapore Med J, 2013 Oct;54(10):e208-10.

PMID: 24154590

Isolated laryngeal histoplasmosis is a very rare entity. It has variable clinical presentations that might mimic both benign and malignant lesions, and is usually associated with pulmonary and other disseminated forms of histoplasmosis. Herein, we report a case of primary laryngeal histoplasmosis without the involvement of other systems in a 70-year-old Chinese man, who previously worked as a miner. He presented with a history of hoarseness for two months, with no other associated symptoms. Direct laryngoscopy revealed irregularity of the posterior one-third of both vocal folds. Histopathological examination revealed the presence of Histoplasma capsulatumon periodic acidSchiff and Grocott's methenamine silver staining. The lesion resolved after one month of oral itraconazole treatment. However, the patient had to complete six months of antifungal treatment to prevent recurrence.

Matched MeSH terms: Histoplasmosis/diagnosis; Histoplasmosis/drug therapy; Histoplasmosis/microbiology*

Cystic tumor of papillary muscle of heart: a rare finding in sudden death

Murty OP

Am J Forensic Med Pathol, 2009 Jun;30(2):201-3.

PMID: 19465820 DOI: 10.1097/PAF.0b013e31819d9af5

Primary cystic tumors of papillary muscles of the heart are extremely rare. Here, one case of unusual cystic tumor in papillary muscle of the heart in a 37-year-old Myanmar migrant worker has been reported. He came to Malaysia 2 weeks before and one morning was found dead in sleep. Autopsy revealed cystic lesion in the papillary muscle of the mitral valve of heart, which was prolapsing into ventricular cavity. The cyst had white-jelly like sticky mucus material. The cyst was present in papillary muscle with slight invasion in septum area; it was lined by cuboidal-columnar epithelium and contained mucinous contents. There was no evidence of an inflammatory reaction in the cyst and in cardiac muscles. In addition to cystic neoplasm, the deceased also had histoplasmosis of the lungs. The case is presented with macroscopic and microscopic photographs of the cyst and histoplasmosis of the lungs. This case is reported because of its rarity, unique position, and unusual appearance.

Matched MeSH terms: Histoplasmosis/pathology

Histoplasmosis: long term remission following treatment with low dose amphotericin-B

Eravelly J, Ramanathan K, Eapen JS

Med J Malaysia, 1975 Sep;30(1):59-62.

PMID: 1236666

Matched MeSH terms: Histoplasmosis/drug therapy*

Histoplasmosis in Malaya

Ponnampalam JT

Br J Dis Chest, 1964 Apr;58:49-55.

PMID: 14152216

A survey of 227 patients from 5-60 years of age revealed the presence of positive histoplasmin skin tests in 10.5 per cent. and positive complement-fixation tests in 19-8 per cent. Sputum from 13 of the 37 patients who had a positive complement-fixation test were cultured for H. capsulatum but with negative results. Exposure to infection by the fungus is equally distributed among the different race and age groups. A careful and constant watch should be kept for histoplasmosis in all chest hospitals as a certain number of cases may be present. It tends to elude diagnosis unless specially sought as it resembles the clinical picture of tuberculosis or other granulomatous disease. It presents a field for further investigation and research in Malaya.

Matched MeSH terms: Histoplasmosis*

Sensitivity to tuberculin, PPD-B and histoplasmin in the population of Sabah in East Malaysia

Roy RN

Med J Aust, 1971 Feb 06;1(6):317-21.

PMID: 5546216

Matched MeSH terms: Histoplasmosis/diagnosis

Disseminated histoplasmosis mimicking an acute appendicitis

Marsilla MM, Khairunisa AA, Azyani Y, Petrick P

Malays J Pathol, 2019 Aug;41(2):223-227.

PMID: 31427560

INTRODUCTION: Histoplasmosis can present in a myriad of clinical manifestations, which often makes its diagnosis difficult and occasionally, deceptive.

CASE REPORT: We describe a case of a 33 years old gentleman who was clinically diagnosed as acute appendicitis at initial presentation in view of a one-week history of fever, right lower quadrant abdominal pain- and guarding at right iliac fossa. He had thrombocytopenia and lymphopenia on presentation. Mesenteric lymphadenitis and small bowel lesion were found intraoperatively, which was respectively biopsied and resected. Histopathological result confirms disseminated histoplasmosis. Retroviral screen was positive. He was treated with amphotericin B for one week, subsequently switched to oral itraconazole, followed by initiation of highly active antiretroviral therapy (HAART).

DISCUSSION: This case illustrates the various nature of histoplasmosis presentation. A high index of suspicion is needed to clinch the diagnosis and subsequently institute prompt treatment as disseminated disease can be fatal if left untreated in an immunosuppressed host.

Matched MeSH terms: Histoplasmosis

Fulltext A case report on biochemical aberrations in disseminated histoplasmosis: the clues toward addison’s disease

Izzatul Aliaa Badaruddin, Dian Nasriana Nasuruddin, Hanita Othman, Munirah Mansor

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):348-350.

MyJurnal

The incidence of Addison’s disease (AD) is rare. One of the most common causes of AD in developed countries is autoimmune. On the other hand, in developing countries, infective causes still predominate. The symptoms are mostly insidious in onset and non-specific, making it challenging to diagnose AD. The delay in starting the right treatment predisposes to high mortality due to Addison’s crisis. Hence, biochemical parameters play a vital role in diagnosing AD since they usually will present with prominent hyponatraemia, hyperkalaemia and hypoglycaemia. Here, we report a case of a 66-year-old man with multiple co-morbidities and disseminated histoplasmosis who pre- sented with asymptomatic hyponatraemia and hyperkalaemia and was eventually diagnosed with Addison’s disease. Although the non-specific symptoms from his multiple co-morbidities obscured the diagnosis of AD, comprehensive biochemical tests have helped in establishing the diagnosis.

Matched MeSH terms: Histoplasmosis

The Malaysian Medical Association's role in public health control for reduction of bird dropping hazards in Sarawak

Hock RH

Aust N Z J Public Health, 2009 Apr;33(2):194-5.

PMID: 19413867 DOI: 10.1111/j.1753-6405.2009.00370.x

Matched MeSH terms: Histoplasmosis/prevention & control*

Fulltext Mapping histoplasmosis in South East Asia - implications for diagnosis in AIDS

Baker J, Setianingrum F, Wahyuningsih R, Denning DW

Emerg Microbes Infect, 2019;8(1):1139-1145.

PMID: 31364950 DOI: 10.1080/22221751.2019.1644539

Histoplasmosis caused by the fungus Histoplasma capsulatum is often lethal in patients with AIDS. Urine antigen testing is highly sensitive and much quicker for diagnosis than culture. Histoplasmosis has a patchy and incompletely appreciated distribution around the world especially in South East Asia. We conducted a systematic literature review of cases of all disease forms of histoplasmosis in SE Asia, not including the Indian sub-continent. We also reviewed all histoplasmin skin test mapping studies to determine localities of exposure. We found a total of 407 cases contracted or likely to have been contracted in SE Asia. Numbers of cases by country varied: Thailand (233), Malaysia (76), Indonesia (48) and Singapore (21), with few or no cases reported in other countries. Most cases (255 (63%)) were disseminated histoplasmosis and 177 (43%) cases were HIV associated. Areas of high histoplasmin skin test sensitivity prevalence were found in Myanmar, the Philippines, Indonesia, Thailand and Vietnam - 86.4%, 26.0%, 63.6%, 36.0% and 33.7%, respectively. We have drawn maps of these data. Further study is required to ascertain the extent of histoplasmosis within SE Asia. Diagnostic capability for patients with HIV infection is urgently required in SE Asia, to reduce mortality and mis-diagnosis as tuberculosis.

Matched MeSH terms: Histoplasmosis/epidemiology*

Oral histoplasmosis in Malaysia: A retrospective analysis of cases reported in Stomatology Unit, Institute for Medical Research during 1995-2016

Noratikah AH, Ajura AJ, Lau SH

Trop Biomed, 2018 Dec 01;35(4):1041-1048.

PMID: 33601851

Histoplasmosis is a systemic fungal infection caused by inhalation of Histoplasma capsulatum, which is mainly found in bird and bat droppings. Oral manifestation of histoplasmosis may be the only initial manifestation of the disease or associated with chronic disseminated histoplasmosis. The first review of oral histoplasmosis among Malaysian population from 1967 to 1994 (27 years) revealed the occurrence of 37 cases, reported by Ng and Siar in 1996. This current study is the updated overview of oral histoplasmosis cases in Malaysia. The objective of the study was to review and describe clinical and demographic profile of oral histoplasmosis in Malaysia and to correlate histopathological features of oral histoplasmosis with patient's immunity status. We reviewed oral histoplasmosis cases diagnosed in Stomatology Unit, Institute for Medical Research (IMR), Kuala Lumpur from 1995 until 2016. The data was retrieved from the Oral Pathology Information system (OPIS) Stomatology Unit, IMR, which is the largest oral pathology database in Malaysia. Information regarding patients' sociodemographic data, medical illness, clinical presentation, histopathological features, and referring healthcare institutions was extracted from the clinical information which accompanied the biopsy request form. A total of 39 cases of oral histoplasmosis were identified from 1995-2016. Majority of them were male (89.7%). The age ranges from 29 to 85 years with mean age of 57.8 years. Almost half of them were Malays (51.3%), followed by Chinese (33.3%), Indians (7.7%), and other races (7.7%). The most common sites of oral histoplasmosis were tongue, gingiva, palate, and alveolar ridge. The main clinical presentation was ulcer (61.5%) whereas 38.5% presented clinically as swelling. 17.9% of patients were seropositive for human immunodeficiency virus (HIV), 12.8% had tuberculosis, 10.3% had diabetes mellitus, and 2.6% with hepatitis C. The incidence of oral histoplasmosis should raise suspicion of hidden immunodepression and may be the first manifestation of acquired immunodeficiency syndrome (AIDS). Early recognition and diagnosis is crucial to reduce risk of morbidity and mortality.

Matched MeSH terms: Histoplasmosis

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