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. 2022 Jan 21;9:20499361211068592. doi: 10.1177/20499361211068592

Table 5.

Co-occurrence of pediatric histoplasmosis with TB/pneumonia.

Sex/Age/Country Clinical findings HIV Initial diagnosis Diagnostic method/Final diagnosis Treatment/outcome References
M/12/
Guinea-Bissau
Multiple cervical nodules, axillary, and inguinal cutaneous fistulas. Painful supra pubic abdominal mass. CT scan: micro-nodules and hilar calcifications on the left lower lobe. Sputum culture for TB was positive. N Lymphoma/Pulmonary TB Cervical nodular biopsy: Histoplasma duboisii, swab cultures of the exudates: Histoplasma duboisii 6 months course of anti-TB therapy but did not improve. Patient recovered with Posaconazole Gonçalves et al. 32
M/12/
Tanzania
Productive cough and intermittent low-grade evening fevers for 1 year and shortness of breath of 1 week duration N TB/Recurrent TB AFB; initially positive, then became negative after completion of anti-TB therapy. Post-mortem findings showed yeast cells suggestive of Histoplasma capsulatum No improvement after commencement of anti TB therapy and repeated anti-TB therapy. Patient died Kabangila et al. 24
F/8/
South Africa
Fever, malaise, and respiratory distress. Examination findings: pallor with generalized lymphadenopathy. Punched out painless ulcer on her left lower leg, ulcerative lesions on the tip of her tongue and the angle of her mouth; tender hepatomegaly. Chest radiograph: right upper lobe consolidation with cavitation. Direct immunofluorescence and culture of the oral lesions yielded herpes simplex type 1. P Herpesvirus infection, severe community-acquired pneumonia, Pneumocystis carinii infection Bone marrow aspirate and trephine biopsy (revealed yeast forms of H. capsulatum /DH Patient died before antifungal therapy could be commenced. Postmortem specimens from lung, liver, lower limb skin lesion and lymph node demonstrated histoplasmosis. Pillay et al. 27

AFB, acid-fast bacilli; CT, computed tomography; DH, disseminated histoplasmosis; N, negative; P, positive; TB, tuberculosis.