Acute Histoplasmosis with Pleural Effusion in an Immunocompetent Patient

Patty W. Liddell; Kathleen Kenwright; Ashley N. Crawford

doi:10.29074/ascls.28.1.8

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Patty W. Liddell, MS, CLS⇑
1. Baptist College of Health Sciences, 1003 Monroe Avenue, Memphis, TN
Kathleen Kenwright, MS, MLS(ASCP)SI, MB
1. Depart-ment of Clinical Laboratory Sciences, University of Tennessee Health Science Center, Memphis, TN
Ashley N. Crawford, BS, BA
1. Bachelor Nursing Student, Baptist College of Health Sciences, 1003 Monroe Avenue, Memphis, TN

Address for Correspondence: Patty W. Liddell MS, CLS, SH, Baptist College of Health Science, 1003 Monroe, Memphis, Tn. 38104, (901) 619-0732 cell, (901) 572-2556 office patty.liddell{at}bchs.edu

Abstract

Histoplasmosis is a mycosis caused by the organism Histoplasma capsulatum and is transmitted to humans through aerosol and ingestion. It is endemic in several areas of the United States, Central and South America and has variants in Europe, Asia and Africa where the mycelial form grows in soil rich in nutrients. When the soil is disturbed, either spores or hyphal elements can spread populating nearby areas or they may be carried by mechanical vectors. It is also possible for infected vectors to spread the fungus. The following case study presents an atypical occurrence of acute severe histoplasmosis in an immunocompetent adult. Included is an overview of the diagnostic process, the organism's history, characteristics, pathogenicity, and host responses.

ABBREVIATIONS: BAL - bronchial alveolar lavage, EIA - enzyme immunoassay, ELISA - enzyme linked immunosorbent assay, NK - natural killer, PAMPS - pathogen associated molecular patterns, PRR- pattern recognition receptors, TLR2 - Toll-like receptors, MR - mannose receptor, T_H1 - T helper cell 1