Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài:Pulmonary histoplasmosis presenting as chronic productive cough, fever, and massive unilateral consolidation in a 15-year-old immunecompetent boy: a case report | Kabangila et al. Journal of Medical Case Reports 2011 5 374 http content 5 1 374 TO. JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Pulmonary histoplasmosis presenting as chronic productive cough fever and massive unilateral consolidation in a 15-year-old immune-competent boy a case report 1 3 3 4 Rodrick Kabangila 1 Kilonzo Semvua Peter Rambau Kahima Jackson Stephen E Mshana Hyasinta Jaka 1 and Robert N Peck1 2 5 Abstract Introduction Severe histoplasmosis is known to be among the AIDS-defining opportunistic infections affecting patients with very low CD4 cell counts in histoplasmosis-endemic areas. Histoplasma capsulatum var. duboisii is common in West and Central Africa where it occurs in both HIV AIDS and non-HIV patients. Few cases of lifethreatening histoplasmosis in immune-competent individuals have been reported worldwide. Case report We describe a case of pulmonary histoplasmosis diagnosed on the basis of autopsy and histological investigations. A 15-year old East African immune-competent boy with a history of smear-positive tuberculosis and a two-year history of rock cutting presented to our hospital with chronic productive cough fever and massive unilateral consolidation. At the time of presentation to our hospital this patient was empirically treated for recurrent tuberculosis without success and he died on the seventh day after admission. The autopsy revealed a huge granulomatous lesion with caseation but no acid-fast bacilli were detected on several Ziehl-Neelsen stains. However periodic acid-Schiff staining was positive and the histological examination revealed features suggestive of Histoplasma yeast cells. Conclusion Severe pulmonary histoplasmosis should be considered in evaluating immune-competent patients with risk factors for the disease who present with pulmonary symptoms mimicking tuberculosis. Keywords histoplasmosis immune-competent consolidation acid-fast bacilli periodic acid-Schiff staining
