PDF(Pubmed)
Abstract：
Histoplasmosis is an endemic disease caused by Histoplasma capsulatum. This systemic disease can affect various organs beyond the lungs, such as the liver, spleen, adrenal gland, and lymph nodes. The clinical symptoms can range from asymptomatic to severe, life-threatening conditions, depending on the state of the patient\'s immune system. This report describes a 40-year-old male who presented with reports of weight loss, low back pain, and progressively worsening movement disorder of the bilateral lower extremities for months. Computed tomography (CT) examination showed multiple lytic lesions of vertebral bodies, bilateral ribs, and pelvic bone, histopathological examination and tumor-related serum markers exclude tumors. mNGS was employed to identify H. capsulatum var. capsulatum as the etiological agent of the lesions in the bone biopsy. Through phylogenetic tree analysis, Histoplasma capsulatum var. Capsulatum (Hcc) was the main responsible pathogen, rarely reported in bone lesions. The patient underwent spinal surgery and was successfully treated with liposomal amphotericin B and itraconazole. Based on the diagnosis and treatment of this case, we discuss the epidemiologic status, clinical presentations, diagnostic criteria, and treatment guidelines of histoplasmosis to provide additional information about this disease. mNGS is utilized in this case, and it appears to be a reliable method for early and accurate diagnosis of this disease.
摘要：
组织胞浆菌病是由荚膜组织胞浆菌引起的地方病。这种全身性疾病可以影响肺部以外的各种器官，比如肝脏，脾,脾肾上腺,和淋巴结。临床症状可以从无症状到严重，危及生命的状况,取决于患者的免疫系统状态。这份报告描述了一名40岁的男性，他提交了减肥报告，腰痛,和逐渐恶化的双下肢运动障碍几个月。计算机断层扫描（CT）检查显示椎体多发溶解性病变，双侧肋骨,和骨盆骨,组织病理学检查和肿瘤相关血清标志物排除肿瘤。mNGS用于鉴定荚膜H.包膜是骨活检中病变的病因。通过系统发育树分析，荚膜组织胞浆变种。荚膜（Hcc）是主要的病原，很少在骨病变中报告。该患者接受了脊柱手术，并成功使用脂质体两性霉素B和伊曲康唑治疗。根据这个病例的诊断和治疗,我们讨论流行病学状况，临床表现,诊断标准,和组织胞浆菌病的治疗指南，以提供有关该疾病的其他信息。在这种情况下使用mNGS，它似乎是早期和准确诊断这种疾病的可靠方法。
