Van Tran Cam, Nguyen Sau V, Nguyen Thuong V, Hoang Ha Thi T, Pham Phuong Thi Minh, Do Hien Thi T, Vu Ha T, Dao Ghi H, Nguyen Long H, Cantarelli Vlademir Vicente, Silva Victor
National Hospital of Dermatology and Venereology, Dong Da Dist, Ha Noi, Viet Nam.
Universidade Feevale and UFCSPA, Brazil.
Rev Iberoam Micol. 2019 Jul-Sep;36(3):147-150. doi: 10.1016/j.riam.2019.04.002. Epub 2019 Aug 2.
Histoplasmosis is a systemic infection caused by the dimorphic fungus Histoplasma capsulatum, naturally found in nitrogen-rich soil, whose main transmission route is the inhalation of conidia. Up to 95% of histoplasmosis cases are asymptomatic or transient, and the remaining 5% of cases have pathological manifestations in the lungs, bone marrow, liver, spleen, intestine, mucous membranes, and rarely on the skin. This mycosis has been reported from many endemic areas, mainly in immunosuppressed patients, such as HIV-positive patients, and its disseminated form is rarely reported.
Histoplama capsulatum was isolated and identified by means of microscopy, culture characteristics and nested PCR from the cutaneous lesions of a non-HIV patient from Vietnam. The patient improved significantly with systemic itraconazole treatment.
Disseminated histoplasmosis with cutaneous involvement in non-HIV patients is an extremely unusual presentation.
组织胞浆菌病是一种由双相真菌荚膜组织胞浆菌引起的全身性感染，该真菌自然存在于富氮土壤中，其主要传播途径是吸入分生孢子。高达95%的组织胞浆菌病病例无症状或呈短暂性，其余5%的病例在肺部、骨髓、肝脏、脾脏、肠道、黏膜出现病理表现，很少累及皮肤。许多流行地区都报告过这种真菌病，主要见于免疫抑制患者，如艾滋病毒阳性患者，其播散型很少见。
通过显微镜检查、培养特性和巢式聚合酶链反应从一名来自越南的非艾滋病毒患者的皮肤病变中分离并鉴定出荚膜组织胞浆菌。该患者接受全身性伊曲康唑治疗后显著好转。
非艾滋病毒患者出现累及皮肤的播散性组织胞浆菌病是一种极其罕见的表现。
