Disseminated histoplasmosis with oral involvement and co-infection with Pneumocystis in a patient with HIV: A case report
Oral manifestations of disseminated histoplasmosis are rare but can present in immunocompromised individuals. We report a case of disseminated Histoplasmosis presenting with presumed oral involvement and Pneumocystis jirovecii pneumonia in a seropositive HIV individual. A 32-year-old male with HIV p...
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Elsevier
2025-01-01
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214250924001951 |
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| author | Susanne O Ajao Nehar Damle Michelle Zhao Gabriela Ferreira Keith S Kaye John P Mills |
| author_facet | Susanne O Ajao Nehar Damle Michelle Zhao Gabriela Ferreira Keith S Kaye John P Mills |
| author_sort | Susanne O Ajao |
| collection | DOAJ |
| description | Oral manifestations of disseminated histoplasmosis are rare but can present in immunocompromised individuals. We report a case of disseminated Histoplasmosis presenting with presumed oral involvement and Pneumocystis jirovecii pneumonia in a seropositive HIV individual. A 32-year-old male with HIV presented to the emergency department for a two-week history of abdominal pain and a tongue ulcer in the setting of significant weight loss, blood-tinged sputum, and non-adherence with antiretroviral therapy for three years. Physical exam revealed a verrucous ulcer on the lateral aspect of the tongue. CT scan of the chest revealed diffuse bilateral pulmonary nodules and ground glass opacities. At presentation, his CD4 + count was 12 cells/mm3. During his hospitalization, he developed acute hypoxic respiratory failure requiring non-invasive ventilation. His urine histoplasma antigen was positive at greater than 25 ng/mL and liposomal amphotericin was started. Shortly thereafter, Pneumocystis jirovecii PCR on bronchoalveolar lavage returned positive prompting additional therapy with trimethoprim-sulfamethoxazole. At discharge, the patient had no respiratory symptoms and near-resolution of his tongue ulcer. |
| format | Article |
| id | doaj-art-ca0318d9b62c459cbd87b4eab4b9a2ab |
| institution | DOAJ |
| issn | 2214-2509 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj-art-ca0318d9b62c459cbd87b4eab4b9a2ab2025-08-20T02:57:32ZengElsevierIDCases2214-25092025-01-0139e0211910.1016/j.idcr.2024.e02119Disseminated histoplasmosis with oral involvement and co-infection with Pneumocystis in a patient with HIV: A case reportSusanne O Ajao0Nehar Damle1Michelle Zhao2Gabriela Ferreira3Keith S Kaye4John P Mills5Rutgers Robert Wood Johnson Medical School, Division of Infectious Diseases, New Brunswick, NJ, United States; Correspondence to: 1 Robert Wood Johnson Place, New Brunswick, NJ 08901, United States.Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United StatesRutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United StatesRutgers Robert Wood Johnson Medical School, Department of Medicine, New Brunswick, NJ, United StatesRutgers Robert Wood Johnson Medical School, Division of Infectious Diseases, New Brunswick, NJ, United StatesRutgers Robert Wood Johnson Medical School, Division of Infectious Diseases, New Brunswick, NJ, United StatesOral manifestations of disseminated histoplasmosis are rare but can present in immunocompromised individuals. We report a case of disseminated Histoplasmosis presenting with presumed oral involvement and Pneumocystis jirovecii pneumonia in a seropositive HIV individual. A 32-year-old male with HIV presented to the emergency department for a two-week history of abdominal pain and a tongue ulcer in the setting of significant weight loss, blood-tinged sputum, and non-adherence with antiretroviral therapy for three years. Physical exam revealed a verrucous ulcer on the lateral aspect of the tongue. CT scan of the chest revealed diffuse bilateral pulmonary nodules and ground glass opacities. At presentation, his CD4 + count was 12 cells/mm3. During his hospitalization, he developed acute hypoxic respiratory failure requiring non-invasive ventilation. His urine histoplasma antigen was positive at greater than 25 ng/mL and liposomal amphotericin was started. Shortly thereafter, Pneumocystis jirovecii PCR on bronchoalveolar lavage returned positive prompting additional therapy with trimethoprim-sulfamethoxazole. At discharge, the patient had no respiratory symptoms and near-resolution of his tongue ulcer.http://www.sciencedirect.com/science/article/pii/S2214250924001951HIV-AIDSHistoplasmosisPneumocystisFungal infectionsInfections in the immunocompromised host |
| spellingShingle | Susanne O Ajao Nehar Damle Michelle Zhao Gabriela Ferreira Keith S Kaye John P Mills Disseminated histoplasmosis with oral involvement and co-infection with Pneumocystis in a patient with HIV: A case report IDCases HIV-AIDS Histoplasmosis Pneumocystis Fungal infections Infections in the immunocompromised host |
| title | Disseminated histoplasmosis with oral involvement and co-infection with Pneumocystis in a patient with HIV: A case report |
| title_full | Disseminated histoplasmosis with oral involvement and co-infection with Pneumocystis in a patient with HIV: A case report |
| title_fullStr | Disseminated histoplasmosis with oral involvement and co-infection with Pneumocystis in a patient with HIV: A case report |
| title_full_unstemmed | Disseminated histoplasmosis with oral involvement and co-infection with Pneumocystis in a patient with HIV: A case report |
| title_short | Disseminated histoplasmosis with oral involvement and co-infection with Pneumocystis in a patient with HIV: A case report |
| title_sort | disseminated histoplasmosis with oral involvement and co infection with pneumocystis in a patient with hiv a case report |
| topic | HIV-AIDS Histoplasmosis Pneumocystis Fungal infections Infections in the immunocompromised host |
| url | http://www.sciencedirect.com/science/article/pii/S2214250924001951 |
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