CASE ANALYSIS

(HISTOPLASMOSIS)
T R I B E D E U T E R O M Y C O TA

HISTORY OF THE CASE

The patient is a 53-year old female Australian with
no significant medical history.
She works as a library attendant.
In 1993, she travelled throughout Europe and to
North-Eastern Coast of the US.

PERTINENT FINDINGS
Signs and Symptoms
Positive chronic lesion affecting the gingiva and
buccal mucosa of right mandible
Positive
untreated,
generalized
moderate
periodontitis and localized advanced bone loss
developing to ulcerative gingivitis
Histology Results
Granulomatous inflammation with giant cells and
macrophages containing yeast-like bodies

Chronic lesion affecting the

gingiva and buccal mucosa
of right mandible

macrophages containing yeastlike bodies

PERTINENT FINDINGS
Culture
On BHI agar at 28 degrees: small white mold after
14 days
Slide: positive for tuberculated macroconidia
Subcultures at 35 degrees after 28 days: yeast form
was observed

PRESUMPTIVE DIAGNOSIS
Samples of tissue or body fluids are plated onto BHI and
incubated at 25C. After several weeks, and sometimes as long
as 6 weeks, growth of a white to light tan mold occurs. Two
types of conidia are produced on the hyphae. The
macroconidia, or tuberculate conidia, are 8 to 15 m in
diameter and have distinctive projections on their surface; the
microconidia are small (2 to 4 m) and smooth walled.
Identification of the tuberculate macroconidia allows a
presumptive diagnosis of histoplasmosis; however, it should be
noted that fungi belonging to the genus Sepedonium also form
similar tuberculate macroconidia. A definitive test to verify that
the mold is H. capsulatum should always be performed.

Granulomatous
Disease

APPROA
CH TO
THE
CAUSATI
VE

Growth on BHI

giant cells and

macrophages
containing yeastlike bodies

Small white mold

(Mycelial form)

Tuberculated
Macroconidia

Yeast form (at 35

degrees after 28
days)

FINAL IDENTIFICATION

FINAL IDENTIFICATION
The 53 year old Australian female has the systemic
mycosis histoplasmosis which she may have acquired
during her travel to the North-Eastern Coast of the US.
Histoplasmosis is obtained by humans from airborne
microconidia. More than 95% of cases have either no
symptoms or mild symptoms like coughing, fever, and
joint pain. Lesions may appear in the lungs and show
calcification. Most infections resolve on their own and
the disease rarely disseminate.

FINAL DIAGNOSIS
The fungus responsible for the said mycosis is
Histoplasma capsulatum which is evident from the
results of the histology, culture, and subculture of the
tissue specimen. The histology shown granulomatous
inflammation with giant cells and macrophages with
oval yeast-like bodies; the culture on BHI agar at 28C
shown growth of small white mold after 14 days; and
the subculture incubated at 35C shown growth of
yeast after 28 days.

FACTS ABOUT
HISTOPLASMOSIS

Histoplasmosis is disease caused by an infection with

a fungus, Histoplasma capsulatum.
The infection results from inhaling airborne spores of
the fungus.
The fungus is common in the U.S. in the Ohio and
Mississippi River valleys and is often found in soil
contaminated by bird or bat droppings.
Most people who are exposed to the fungus do not
develop the disease.
Cases have also been found in other areas of N.
America nad S. America.

FACTS ABOUT
HISTOPLASMOSIS

The disease is most severe in people with reduced

immune function.
Symptoms of histoplasmosis are similar to those of
pneumonia.
Mild cases of histoplasmosis do not require specific
treatment; more severe or disseminated infections
require antifungal medications.
There is no vaccine available to prevent
histoplasmosis.

REFERENCES
Delost, M. (1997). Introduction to Diagnostic Microbiology: A Text and
Workbook.
Prescott, L. (2002). Microbiology (5th Edition).
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1797635/
http://www.medicinenet.com/histoplasmosis_facts/page2.htm

TRIBE DEUTEROMYCOTA
Leader: Gamboa, Lois
Danielle
Bautista, Joseph
Ryan
Garung, Ralph Jeric
Marilag, Maria Xenia
Yves
Moral, Claire