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| Histoplasma | ||
| Etiology Inhalation of Histoplasm capsulatum from dust contaminated with bird dropping | ||
| Pathogenesis Inhale the microconidia (small spores) Dimorphic fungus with conidia and yeasts at body temperature and hyphae outside the body Yeasts and conidia bind LFA-1 and MAC-1 Phagocytosed by macrophages (obligate intracellular parasites) Killed by T cells that recognize the antigens as well as TNF-alpha, | ||
| Epidemiology Frequent in individuals living along the Ohio and Mississippi rivers Also frequent in individuals living in the Carribean | ||
| General Gross Description Granulomatous lesions that fibrose to form round, well demarcated firm gray white lesions Apical and pleural involvement may occur Diffuse pneumonic process in the immunocompromised host Examples: | ||
| General Microscopic Description Epithelioid granulomas that caseate, then fibrose (resemble lesions of Mycobacteria tuberculosis) Immunocompromised patient may lack the ability to form granulomas but show diffuse macrophage proliferation containing organisms. Examples: | ||
| References Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 327-28. This link will directly take you to the relevant new literature Histoplasma
| Synopsis by: Melinda Sanders M.D. (T28000E41450)[352]
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