Peddi V R, Hariharan S, First M R
Department of Internal Medicine, University of Cincinnati Medical Center, OH 45267-0585, USA.
Clin Transplant. 1996 Apr;10(2):160-5.
Histoplasmosis, an opportunistic fungal infection endemic in the Ohio and Mississippi river valleys, is caused by a dimorphic fungus Histoplasma capsulatum. Most infections are asymptomatic or self-limited febrile illness. Immunosuppressed renal transplant recipients are susceptible to a disseminated disease. We report 5 cases of disseminated histoplasmosis seen in our institute over a period of 25 years amongst 1074 renal transplant recipients. The duration of immunosuppression prior to the diagnosis of infection ranged from 84 days to 14 years. All patients had pulmonary involvement. Three patients received an antilymphocyte preparation and 1 patent received intravenous pulse steroids in the 3 months prior to the onset of infection. Histopathologic examination of the involved organ(s) provided rapid diagnostic information allowing early treatment with amphotericin B. All infections resolved with no relapses to date. In conclusion immunosuppressed patients are more prone to disseminated histoplasmosis. Early recognition and prompt treatment with amphotericin B resolved the infection without relapse.
组织胞浆菌病是一种在俄亥俄河和密西西比河流域流行的机会性真菌感染，由双相真菌荚膜组织胞浆菌引起。大多数感染为无症状或自限性发热疾病。免疫抑制的肾移植受者易患播散性疾病。我们报告了在我们研究所25年间1074例肾移植受者中见到的5例播散性组织胞浆菌病病例。感染诊断前免疫抑制的持续时间为84天至14年。所有患者均有肺部受累。3例患者在感染发作前3个月接受了抗淋巴细胞制剂治疗，1例患者接受了静脉脉冲类固醇治疗。对受累器官进行组织病理学检查可提供快速诊断信息，从而允许早期使用两性霉素B治疗。所有感染均已治愈，迄今为止无复发。总之，免疫抑制患者更容易发生播散性组织胞浆菌病。早期识别并及时使用两性霉素B治疗可使感染得到解决且无复发。
