Document Detail

Acute pulmonary histoplasmosis: progressive pneumonia resulting from high inoculum exposure.
MedLine Citation:
PMID:  9676066     Owner:  NLM     Status:  MEDLINE    
Histoplasmosis is endemic in certain areas of North, Central, and South America, especially within the Ohio and Mississippi River Valleys of the United States. We describe a case of histoplasmosis in a farm-dwelling resident of Kentucky who probably had multiple prior opportunities for exposure. However, during the gathering of topsoil containing chicken droppings for use as fertilizer, he was likely to have been exposed to such a high inoculum of the organism that he developed a severe pulmonary infection. He presented with a one-week history of malaise, myalgias, fever to 103 degrees F, and headaches. A chest X-ray showed bilateral reticulonodular infiltrates. He was initially treated for community-acquired pneumonia. When his symptoms did not resolve, a bronchoscopy was performed. Washings from the broncho-alveolar lavage grew Histoplasma capsulatum, and he responded well to itraconazole therapy. This case is presented to emphasize risks from high-inoculum exposure and the hazard imposed by harvesting certain types of organic material for use as fertilizer.
L T Meals; W P McKinney
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Journal of the Kentucky Medical Association     Volume:  96     ISSN:  0023-0294     ISO Abbreviation:  J Ky Med Assoc     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-08-07     Completed Date:  1998-08-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7505615     Medline TA:  J Ky Med Assoc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  258-60     Citation Subset:  IM    
Department of Veterans Affairs Medical Center, Louisville, KY, USA.
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MeSH Terms
Acute Disease
Antifungal Agents / therapeutic use
Diagnosis, Differential
Disease Progression
Follow-Up Studies
Histoplasma / isolation & purification
Histoplasmosis / drug therapy,  microbiology*,  radiography
Itraconazole / therapeutic use
Lung Diseases, Fungal / drug therapy,  microbiology*,  radiography
Middle Aged
Pneumonia, Bacterial / diagnosis
Radiography, Thoracic
Tomography, X-Ray Computed
Reg. No./Substance:
0/Antifungal Agents; 84625-61-6/Itraconazole

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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