Histoplasmosis presenting as cellulitis 18 years after renal transplantation

A 49-year-old renal transplant patient, under an 18-year course of immunosuppressive therapy with prednisone and azathioprine and, more recently, prednisone plus mycophenolate sodium, developed a cutaneous-subcutaneous infection caused by Histoplasma capsulatum. The clinical presentation consisted o...

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Bibliographic Details
Published in:Medical mycology (Oxford) 2008-11, Vol.46 (7), p.725-728
Main Authors: Marques, Silvio A., Hozumi, Silvia, Camargo, Rosângela M. P., Carvalho, Maria Fernanda C., Marques, Mariangela E. A.
Format: Article
Language:English
Subjects:
Cellulitis - drug therapy
Cellulitis - etiology
Cellulitis - microbiology
Female
Histoplasma - isolation & purification
Histoplasma capsulatum
Histoplasmosis - complications
Histoplasmosis - drug therapy
Histoplasmosis - immunology
Histoplasmosis - microbiology
Humans
Immunocompromised Host
Itraconazole - therapeutic use
Kidney Transplantation
Middle Aged
Treatment Outcome
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Summary:A 49-year-old renal transplant patient, under an 18-year course of immunosuppressive therapy with prednisone and azathioprine and, more recently, prednisone plus mycophenolate sodium, developed a cutaneous-subcutaneous infection caused by Histoplasma capsulatum. The clinical presentation consisted of a slowly enlarging, erythematous and infiltrative 25 cm plaque in the major axis on the arm. There was no involvement of the lungs or any other organ. Cure was obtained with itraconazole treatment after 12 months. Histoplasmosis is an uncommon opportunistic infection among solid organ transplanted patients with incidence of 0% to 2.1% observed in a large number of cases. This report describes an atypical cutaneous clinical presentation of a potentially fatal disease in immunosuppressed patients.
ISSN:1369-3786
1460-2709
DOI:10.1080/13693780802247736