Histoplasmosis diseminada. Informe de un caso de autopsia y revisión de la literatura

Abstract

OBJECTIVE: A DISSEMINATED HISTOPLASMOSIS CASE IN A 26-YEARS-OLD FEMALE PATIENT IS REPORTED, WITH ELISANEGATIVE TO HIV, WHO DIED AS A RESULT OF SEPTIC SHOCK AND DISSEMINATED INTRAVASCULAR COAGULATION. THE CASE IS ANALYZED IN THE CONTEXT OF A MEDICAL LITERATURE REVIEW. STUDY DESIGN: CASE REPORT AND LITERATURE REVIEW. METHODS: COMPLETE CLINICAL HISTORY, NECROPSY ANALYSIS, AND HISTOPATHOLOGICAL STUDY USING H&E, PAS, GROCOTT AND IMMUNOHISTOCHEMICAL STAINING AND TRANSMISSION ELECTRON MICROSCOPY. RESULTS: PATIENT COURSED WITH SYMPTOMATOLOGY OF PELVIC INFLAMMATORY DISEASE, A LUNG CONDITION, AND FEBRILE AND WASTING SYNDROMES. PATIENT EVOLVED WITH ACUTE ABDOMEN AND SHE DIED AS RESULT OF DISSEMINATED INTRAVASCULAR COAGULATION AND SEPTIC SHOCK. HISTOPLASMA CAPSULATUM YEASTS WERE OBSERVED ASSOCIATED TO THROMBI OR FIBRIN AND FREE OR INSIDE PHAGOCYTIC CELLS, PRACTICALLY OVERALL ORGANS EXAMINED. CANDIDA ALBICANS AND MULTINUCLEATED CELLS WITH INTRANUCLEAR INCLUSIONS, SUGGESTIVE OF INFECTION BY HERPES SIMPLEX VIRUS WERE OBSERVED ON DAMAGED MUCOSA OF THE UPPER DIGESTIVE TRACT. CONCLUSIONS: A CASE OF ACUTE DISSEMINATED HISTOPLASMOSIS IN A DEEP IMMUNOSUPPRESSED FEMALE WITH SIMULTANEOUS INFECTION BY HISTOPLASMA CAPSULATUM, CANDIDA ALBICANS AND HERPES SIMPLEX.