Clinical comparative analysis for pulmonary histoplasmosis and progressive disseminated histoplasmosis.
10.11817/j.issn.1672-7347.2016.12.016
- Author:
Yan ZHANG
1
;
Xiaoli SU
1
;
Yuanyuan LI
1
;
Ruoxi HE
1
;
Chengping HU
1
;
Pinhua PAN
1
Author Information
1. Department of Respirotory Medicine, Xiangya Hospital, Central South University/
Key Cite of National Clinical Research Center for Respiratory Disease, Changsha 410008, China.
- Publication Type:Journal Article
- MeSH:
Abdominal Pain;
etiology;
Amphotericin B;
therapeutic use;
Antifungal Agents;
therapeutic use;
Biopsy;
Cough;
epidemiology;
Death;
Deoxycholic Acid;
therapeutic use;
Diagnostic Errors;
Drug Combinations;
Fever;
etiology;
Hepatomegaly;
etiology;
Histoplasma;
Histoplasmosis;
complications;
diagnosis;
mortality;
therapy;
Humans;
Invasive Fungal Infections;
complications;
diagnosis;
therapy;
Itraconazole;
therapeutic use;
Lung;
microbiology;
surgery;
Lung Diseases, Fungal;
diagnosis;
surgery;
therapy;
Pneumonia;
complications;
mortality;
Recurrence;
Retrospective Studies;
Splenomegaly;
etiology;
Treatment Outcome;
Tuberculosis;
complications;
mortality
- From:
Journal of Central South University(Medical Sciences)
2016;41(12):1345-1351
- CountryChina
- Language:Chinese
-
Abstract:
To compare clinical features, diagnosis and therapeutic effect between pulmonary histoplasmosis and progressive disseminated histoplasmosis.
Methods: A retrospective analysis for 12 cases of hospitalized patients with histoplasmosis, who was admitted in Xiangya Hospital, Central South University during the time from February 2009 to October 2015, was carried out. Four cases of pulmonary histoplasmosis and 8 cases of progressive disseminated histoplasmosis were included. The differences of clinical features, imaging tests, means for diagnosis and prognosis were analyzed between the two types of histoplasmosis.
Results: The clinical manifestations of pulmonary histoplasmosis were mild, such as dry cough. However, the main clinical symptoms of progressive disseminated histoplasmosis were severe, including recurrence of high fever, superficial lymph node enlargement over the whole body, hepatosplenomegaly, accompanied by cough, abdominal pain, joint pain, skin changes, etc.Laboratory examination showed pancytopenia, abnormal liver function and abnormal coagulation function. One pulmonary case received the operation of left lower lung lobectomy, 3 cases of pulmonary histoplasmosis and 6 cases of progressive disseminated histoplasmosis patients were given deoxycholate amphotericin B, itraconazole, voriconazole or fluconazole for antifungal therapy. One disseminated case discharged from the hospital without treatment after diagnosis of histoplasmosis, and 1 disseminated case combined with severe pneumonia and active tuberculosis died ultimately.
Conclusion: As a rare fungal infection, histoplasmosis is easily to be misdiagnosed. The diagnostic criteria depends on etiology through bone marrow smear and tissues biopsy. Liposomeal amphotericin B, deoxycholate amphotericin B and itraconazole are recommended to treat infection for histoplasma capsulatum.
