Abstract
An autochthonous case of epididymal histoplasmosis masquerading as tuberculosis in a 55-year-old male patient is reported from India. It was diagnosed by culture ofHistoplasma capsulatum from semen and by demonstration of the fungus upon re-examination of epididymal biopsy sections previously misinterpreted as tuberculous granuloma. The patient's main complaints were painful epididymal swelling, occasional fever and cough. He was treated successfully by excision of epididymis and vas deferens combined with amphotericin B therapy. This is believed to be the first case of epididymal histoplasmosis to be reported outside the American continent and the fourth of its type reported in the English literature. The case is also noteworthy in thatH. capsulatum was isolated for the first time from semen, and it underlines the importance of mycological culture of semen specimens for diagnosis of genitourinary infections of obscure etiology.
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References
Wise GJ, Silver DA. Fungal infections of the genitourinary system. J Urol 1993; 149: 1377–1388.
Randhawa HS, Khan ZU. Histoplasmosis in India: Current status. Indian J Chest Dis 1995; 36: 193–213.
Mankodi RC, Kanvinde MS, Mohapatra LN. Penile histoplasmosis. Indian J Med Sci 1970; 24: 354–356.
Nayak RG, Ramnarayan K, Rao RV, Shenoy MG. A case ofHistoplasma posthitis. Trop Geogr Med 1984; 36: 309–311.
Talvalkar GV. Histoplasmosis simulating carcinoma. A report of three cases. Indian J Cancer 1972; 9: 149–153.
Boone WT, Allison F Jr. Histoplasmosis. Am J Med 1969; 46. 818–826.
Kauffman CA, Slama TG, Wheat LJ.Histoplasma capsulatum epididymitis. J Urol 1981; 125: 434–435.
Marans HY, Mandell W, Kislak JW, Starrett B, Moussouris HF. Prostatic abscess due toH. capsulatum in the acquired immuno-deficiency syndrome. J Urol 1991; 145: 1275–1276.
Orr WA, Mulholland SG, Walzak MP Jr. Genitourinary tract inolvement with systemic mycoses. J Urol 1972; 107: 1047–1050.
Zighelboim J, Goldfarb RA, Mody D, Williams TW, Bradshaw MW, Harris RL. Prostatic abscess due toHistoplasma capsulatum in a patient with acquired immuno-deficiency syndrome. J Urol 1992; 147: 166–168.
Bersack SR, Howe JS, Rabson AS. Inflammatory pseudopolyposis of the small and large intestine with the Peutz-Jegher Syndrome in case of diffuse histoplasmosis. Am J Roentgenol 1958; 80: 73–75.
Monroe H. Granulomatous orchitis due toHistoplasma capsulatum masquerading as sperm granuloma. J Clin Path 1974; 27: 929–930.
Jayalakshmi P, Goh KL, Soo Hoo TS, Daud A. Disseminated histoplasmosis presenting as penile ulcer. Aust New Zealand J Med 1990; 20: 175–177.
Preminger B, Gevand PS, Lutwick L, Frank R, Minkowitz S, Plotkin N. Histoplasmosis of the penis. J Urol 1993; 149: 845–850.
Gass M, Kobayashi GS. Histoplasmosis: An illustrative case with unusual vaginal and joint involvement. Arch Dermatol 1969; 100: 724–727.
Sills M, Schwartz A, Weg JH. Conjugal histoplasmosis: A consequence of progressive dissemination in the index case after steroid therapy. Annals Intern Med 1973; 79: 221–224.
Wise GH. Fungal infections of the urinary tract. In: PC Walsh, AB Retik, TA Stamey, ED Vaughan Jr. (eds), Campbell's Urology, 6th edn., Vol. 1, pp. 928–950, Saunders, Philadelphia.
Johnston AW, Postlethwaite R, Ewen SW, Hay RJ. Disseminated histoplasmosis. J Infect 1984; 9: 79–82.
Tan V, Wilkins P, Badve S, Coppen N, Lucas S, Hay R, Schon F. Histoplasmosis of the central nervous system. J Neurol Neurosurg Psych 1992; 55: 619–622.
Larsen RA, Bozzette S, McCutchan JA, Chiu J, Leal MA, Richman DD. PersistentCryptococcus neoformans infection of the prostate after successful treatment of meningitis. California Collaborative Treatment Group. Annals Intern Med 1989; 111: 125–128.
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Randhawa, H.S., Chaturvedi, S., Khan, Z.U. et al. Epididymal histoplasmosis diagnosed by isolation ofHistoplasma capsulatum from semen. Mycopathologia 131, 173–177 (1995). https://doi.org/10.1007/BF01102897
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DOI: https://doi.org/10.1007/BF01102897