Disseminated histoplasmosis in a juvenile lupus erythematosus patient

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorFRANCA, Camila M. P.
dc.contributor.authorCAVALCANTE, Erica G.
dc.contributor.authorRIBEIRO, Aline S. M.
dc.contributor.authorOLIVEIRA, Guilherme T.
dc.contributor.authorLITVINOV, Nadia
dc.contributor.authorSILVA, Clovis A.
dc.date.accessioned2013-07-30T17:19:27Z
dc.date.available2013-07-30T17:19:27Z
dc.date.issued2012
dc.description.abstractIntroduction: Histoplasmosis is an infection caused by dimorphic fungus, Histoplasma capsulatum, and it has not been reported in juvenile systemic lupus erythematosus (JSLE) patients, particularly progressive disseminated histoplasmosis (PDH) subtype. Case report: We reported herein a 14-year old girl who was diagnosed with JSLE. Six months later, she had abdominal distension and received prednisone, hydroxychloroquine and azathioprine. Computer tomography evidenced hepatosplenomegaly and multiple mesenteric, mediastinal and retroperitoneal enlarged lymph nodes, forming large conglomerates at the mesentery, suggestive of lymphoproliferative disorder. After 10 days, she had acute surgical abdominal, and underwent a laparotomy and intestinal perforation and conglomerates of lymph nodes were observed. The jejunum biopsy showed perforated acute enteritis with hemorrhage and necrosis, and Grocott staining identified Histoplasma sp. and the culture showed a heavy growth of Histoplasma capsulatum. At that moment liposomal amphotericin B (1.0 mg/Kg/day) was introduced. Despite this treatment she died due to septic shock eight days later. Diffuse Histoplasma capsulatum was evidenced at autopsy. Conclusion: We reported a severe opportunistic infection in JSLE patient with adenopathy and multiple intestinal perforations. This study reinforces the importance of early diagnosis and antifungal therapy, especially in patients with these uncommon clinical manifestations.
dc.description.indexMEDLINE
dc.description.sponsorshipFundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2008/58238-4, 2011/12471-2]
dc.description.sponsorshipConselho Nacional do Desenvolvimento Cientifico e Tecnologico (CNPQ) [302724/2011-7]
dc.description.sponsorshipFederico Foundation
dc.description.sponsorshipNucleo de Apoio a Pesquisa ""Saude da Crianca e do Adolescente"" da USP (NAP-CriAd)
dc.identifier.citationACTA REUMATOLOGICA PORTUGUESA, v.37, n.3, p.276-279, 2012
dc.identifier.issn0303-464X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/1373
dc.language.isoeng
dc.publisherMEDFARMA-EDICOES MEDICAS, LDA
dc.relation.ispartofActa Reumatologica Portuguesa
dc.rightsrestrictedAccess
dc.rights.holderCopyright MEDFARMA-EDICOES MEDICAS, LDA
dc.subjectHistoplasmosis
dc.subjectJuvenile systemic lupus erythematosus
dc.subjectChildren
dc.subjectOpportunistic infection
dc.subject.othergastrointestinal histoplasmosis
dc.subject.otherimmunodeficiency
dc.subject.otherperforation
dc.subject.otherlymphoma
dc.subject.otherdiseases
dc.subject.wosRheumatology
dc.titleDisseminated histoplasmosis in a juvenile lupus erythematosus patient
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalRIBEIRO, Aline S. M.:Univ Sao Paulo, Fac Med, Childrens Hosp, Pediat Rheumatol Unit, Sao Paulo, Brazil
hcfmusp.author.externalOLIVEIRA, Guilherme T.:Univ Sao Paulo, Fac Med, Childrens Hosp, Pediat Rheumatol Unit, Sao Paulo, Brazil
hcfmusp.citation.scopus14
hcfmusp.contributor.author-fmusphcCAMILA MARIA PAIVA FRANCA
hcfmusp.contributor.author-fmusphcERICA GOMES DO NASCIMENTO CAVALCANTE
hcfmusp.contributor.author-fmusphcNADIA LITVINOV
hcfmusp.contributor.author-fmusphcCLOVIS ARTUR ALMEIDA DA SILVA
hcfmusp.description.beginpage276
hcfmusp.description.endpage279
hcfmusp.description.issue3
hcfmusp.description.volume37
hcfmusp.lim.ref2012
hcfmusp.origemWOS
hcfmusp.origem.pubmed23348119
hcfmusp.origem.scopus2-s2.0-84868698915
hcfmusp.origem.wosWOS:000309734700012
hcfmusp.publisher.cityALGES
hcfmusp.publisher.countryPORTUGAL
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hcfmusp.remissive.sponsorshipCNPq
hcfmusp.remissive.sponsorshipFAPESP
hcfmusp.remissive.sponsorshipFederico Foundation
hcfmusp.remissive.sponsorshipUSP
hcfmusp.remissive.sponsorshipCNPq
hcfmusp.remissive.sponsorshipFAPESP
hcfmusp.remissive.sponsorshipFederico Foundation
hcfmusp.remissive.sponsorshipUSP
hcfmusp.scopus.lastupdate2024-05-17
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