Pathologically confirmed histoplasmosis: analysis of 14 cases / 南方医科大学学报

ABSTRACT

<p><b>OBJECTIVE</b>To summarize the features of disease history, clinical manifestations, adjuvant examination results, diagnosis, treatments and outcome of patients with histoplasmosis.</p><p><b>METHODS</b>The clinical data of 14 patients with biopsy-confirmed histoplasmosis between 2000 and 2012 in Nanfang Hospital were analyzed retrospectively.</p><p><b>RESULTS</b>The clinical manifestations of histoplasmosis included fever, productive cough, chest pain, and abdominal pain, accompanied occasionally by neurological symptoms, lymph node enlargement or surface mass. Seven out of the 14 o patients had underlying immunosuppressive conditions, 9 had chest imaging changes, and 2 showed reduced white blood cells, red blood cells and platelets. The cases were initially diagnosis as tuberculosis, malignant tumor, or malignant lymphoma before the definite diagnosis was established pathologically. Ten patients received treatments with itraconazole, amphotericin B, fluconazole or voriconazole, and 9 of them responded favorably to the treatments.</p><p><b>CONCLUSION</b>Histoplasmosis, with a low incidence and diverse clinical manifestations, presents with no specific imaging features to easily cause misdiagnosis and missed diagnosis, and its definite diagnosis relies on pathological examination.</p>