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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Disseminated histoplasmosis in a juvenile lupus erythematosus patient

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Author(s):
Franca, Camila M. P. [1] ; Cavalcante, Erica G. [1] ; Ribeiro, Aline S. M. [1] ; Oliveira, Guilherme T. [1] ; Litvinov, Nadia [2] ; Silva, Clovis A. [3, 1]
Total Authors: 6
Affiliation:
[1] Univ Sao Paulo, Fac Med, Childrens Hosp, Pediat Rheumatol Unit, Sao Paulo - Brazil
[2] Univ Sao Paulo, Fac Med, Childrens Hosp, Infectol Unit, Sao Paulo - Brazil
[3] Univ Sao Paulo, Fac Med, Div Rheumatol, Sao Paulo - Brazil
Total Affiliations: 3
Document type: Journal article
Source: ACTA REUMATOLOGICA PORTUGUESA; v. 37, n. 3, p. 276-279, JUL-SEP 2012.
Web of Science Citations: 7
Abstract

Introduction: 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. (AU)

FAPESP's process: 11/12471-2 - Ovarian reserve, antibody anti-corpus luteum and lower genital tract infection in adult women with systemic lupus erythematosus, Behçet's syndrome and Takayasu's arteritis
Grantee:Clovis Artur Almeida da Silva
Support Opportunities: Regular Research Grants