Cohen P R, Bank D E, Silvers D N, Grossman M E
Department of Dermatology, College of Physicians and Surgeons of Columbia University, New York, New York.
J Am Acad Dermatol. 1990 Sep;23(3 Pt 1):422-8. doi: 10.1016/0190-9622(90)70235-a.
Disseminated histoplasmosis is being diagnosed more frequently in persons infected with the human immunodeficiency virus and is often the initial manifestation of the acquired immunodeficiency syndrome (AIDS). Disease-related cutaneous features of HIV-associated disseminated histoplasmosis are defined as mucocutaneous lesions from which fungal organisms were either cultured or demonstrated histopathologically. We report four HIV-seropositive patients with disseminated histoplasmosis who had culture-positive skin or oral lesions of histoplasmosis and review the specific cutaneous manifestations of HIV-associated disseminated histoplasmosis. Including our patients, disease-related skin and/or mucosal lesions were present in 11% of patients (26% of 239) with HIV-associated disseminated histoplasmosis. The possibility of disseminated histoplasmosis should be considered in all HIV-infected persons and in persons with AIDS risk factors who have fever, weight loss, hepatosplenomegaly, and new cutaneous lesions. An early skin or mucosal biopsy specimen for crushed tissue preparation, histologic evaluation, and fungal culture is a simple, rapid diagnostic procedure.
播散性组织胞浆菌病在感染人类免疫缺陷病毒的人群中诊断更为频繁，且常为获得性免疫缺陷综合征（艾滋病）的初始表现。与艾滋病相关的播散性组织胞浆菌病的疾病相关皮肤特征定义为经培养或组织病理学证实有真菌病原体的黏膜皮肤病变。我们报告了4例艾滋病病毒血清学阳性且患有播散性组织胞浆菌病的患者，他们的皮肤或口腔组织胞浆菌病病变培养呈阳性，并回顾了与艾滋病相关的播散性组织胞浆菌病的特定皮肤表现。包括我们的患者在内，在患有与艾滋病相关的播散性组织胞浆菌病的患者中，11%（239例中的26例）出现了与疾病相关的皮肤和/或黏膜病变。对于所有感染艾滋病病毒的人以及有艾滋病危险因素且出现发热、体重减轻、肝脾肿大和新发皮肤病变的人，都应考虑播散性组织胞浆菌病的可能性。早期采集皮肤或黏膜活检标本进行压碎组织制备、组织学评估和真菌培养是一种简单、快速的诊断方法。
