Preneta Ania, Nada Khaled M, Raja Asima, Kasubhai Moiz
Lincoln Medical and Mental Health Center, Bronx, NY, USA.
Case Rep Infect Dis. 2018 May 20;2018:8740204. doi: 10.1155/2018/8740204. eCollection 2018.
Chronic histoplasmosis is typically diagnosed in patients who are immunocompromised or severely debilitated and who either live in or who have travelled to endemic areas. We report the case of a young, otherwise immunocompetent male patient who presented to a New York hospital with lobar consolidation and was found to have chronic pulmonary histoplasmosis. He described no history of travel to an endemic area. Immunological workup later revealed selective immunoglobulin M (IgM) deficiency. The literature has suggested a link between IgM deficiency and fungal infections. Recent research has also proposed a link between autoimmunity and IgM deficiency. Our clinical vignette describes the case of a patient with selective IgM deficiency who was diagnosed with pulmonary histoplasmosis without any clinical evidence of autoimmune disease.
慢性组织胞浆菌病通常在免疫功能低下或严重虚弱且居住在或前往过流行地区的患者中被诊断出来。我们报告了一例年轻的、免疫功能正常的男性患者，他因肺叶实变到纽约一家医院就诊，被发现患有慢性肺组织胞浆菌病。他表示没有前往过流行地区的病史。免疫检查后来发现选择性免疫球蛋白M（IgM）缺乏。文献表明IgM缺乏与真菌感染之间存在联系。最近的研究还提出自身免疫与IgM缺乏之间存在联系。我们的临床案例描述了一名患有选择性IgM缺乏的患者，他被诊断为肺组织胞浆菌病，且没有任何自身免疫性疾病的临床证据。
