组织胞浆菌病是由荚膜组织胞浆菌引起的全身性真菌感染,以其蛋白质的临床表现而闻名,这些临床表现往往会带来诊断挑战。免疫功能低下的患者,如免疫抑制疗法或艾滋病毒/艾滋病,特别容易受到严重疾病的影响。我们介绍了一个55岁的女性,有复杂的病史,包括肾移植,发烧的人,萎靡不振,恶心,在巴拿马逗留一个月后呕吐.患者的病史包括在家中接触到明显感染和霉菌的鸟类。她的临床表现是急性肾损伤,肝酶升高,无结石性胆囊炎,和肺结节。这种复杂的症状群强调了组织胞浆菌病表现的多样性及其模仿其他疾病的潜力。患者接受了包括影像学的逐步诊断方法,微生物测试,多学科协商。真菌细胞试验阳性,尿液中的组织胞浆检测,和散见亚厘米肺结节的鉴定证实了诊断。这个案例强调了考虑流行地区的重要性,环境暴露,免疫功能低下患者的非典型临床特征。多学科方法促进了脂质体两性霉素B的适当管理和治疗开始,强调在复杂病例中各种医学专业之间合作的重要性。因此,本病例报告强调了在免疫受损个体中诊断和治疗组织胞浆菌病的复杂性,并强调需要对非典型表现进行全面评估.
Histoplasmosis is a systemic fungal infection caused by Histoplasma capsulatum, known for its protean clinical manifestations that often pose diagnostic challenges. Immunocompromised patients, such as those on immunosuppressive therapies or with HIV/AIDS, are particularly susceptible to severe forms of the disease. We present a
case of a 55-year-old female with a complex medical history, including a renal transplant, who developed fever, malaise, nausea, and vomiting after a month-long stay in Panama. The patient\'s history included exposure to a bird with apparent infection and mold in her home. Her clinical presentation featured acute kidney injury, elevated liver enzymes, acalculous cholecystitis, and lung nodules. This intricate constellation of symptoms underscores the diverse nature of histoplasmosis presentations and its potential to mimic other diseases. The patient underwent a stepwise diagnostic approach involving imaging, microbiological tests, and multidisciplinary consultations. The positive Fungitell assay, Histoplasma capsulatum detection in urine, and identification of scattered subcentimeter lung nodules confirmed the diagnosis. This
case underscores the significance of considering endemic areas, environmental exposures, and atypical clinical features in immunocompromised patients. The multidisciplinary approach facilitated appropriate management and treatment initiation with liposomal amphotericin B, highlighting the importance of collaboration among various medical specialties in complex cases. As such, this
case report emphasizes the complexity of diagnosing and managing histoplasmosis in immunocompromised individuals and highlights the need for a comprehensive evaluation of atypical presentations.