Cutaneous histoplasmosis disclosing an HIV-infection Histoplasmose cutânea reveladora de infecção pelo HIV

• Main Authors: Silvio Alencar Marques, Maria Regina Cavariani Silvares, Rosangela Maria Pires de Camargo, Mariangela Esther Alencar Marques
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Dermatologia 2013-06-01
• Series: Anais Brasileiros de Dermatologia
• Subjects: Anfotericina B; Histoplasmose; Síndrome de imunodeficiência adquirida; Acquired immunodeficiency syndrome; Amphotericin B; Histoplasmosis
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0365-05962013000300420
• ISSN: 0365-0596; 1806-4841

Histoplasmosis is a systemic mycosis endemic in extensive areas of the Americas. The authors report on an urban adult male patient with uncommon oral-cutaneous lesions proven to be histoplasmosis. Additional investigation revealed unnoticed HIV infection with CD4+ cell count of 7/mm3. The treatment was performed with amphotericin B, a 2065 mg total dose followed by itraconazole 200mg/daily plus antiretroviral therapy with apparent cure. Histoplasmosis is an AIDS-defining opportunistic disease process; therefore, its clinical diagnosis must drive full laboratory investigation looking for unnoted HIV-infection.<br>Histoplasmose &#233; infec&#231;&#227;o sist&#234;mica end&#234;mica em extensas &#225;reas do continente Americano. Os autores relatam caso de paciente do sexo masculino, de zona urbana com les&#245;es cut&#226;neas e mucosas incomuns de histoplasmose. Investiga&#231;&#227;o adicional posterior revelou infec&#231;&#227;o subjacente pelo HIV com contagem de c&#233;lulas CD4 de 7/mm3. O tratamento foi realizado com anfotericina B, dose total de 2065 mg, seguido por itraconazol 200 mg/dia associado &#224; terap&#234;utica antirretroviral com cura aparente do quadro. Histoplasmose &#233; enfermidade oportun&#237;stica definidora da s&#237;ndrome de imunodefici&#234;ncia adquirida, portanto, diagn&#243;stico clinico de histoplasmose implica em investiga&#231;&#227;o laboratorial de infec&#231;&#227;o subjacente pelo HIV.