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<p><i>Histoplasma capsulatum</i> var. <i>capsulatum</i> is a thermally dimorphic fungus endemic in regions like the Midwestern USA, Africa, and Central/South America. It grows as a mold in the environment and as yeast in human tissues. The disease’s severity and presentation depend mostly on the host’s immunity. In immunocompromised individuals, it often causes progressive disseminated histoplasmosis (PDH), a severe systemic condition. PDH symptoms include pneumonia, enlarged spleen and liver, enteritis, pancytopenia, lymphadenopathy, skin and mucosal lesions, and joint pain, making the diagnosis a challenge. Though more described in Acquired Immunodeficiency Syndrome (AIDS) patients, PDH can also occur in kidney transplant (KT) recipients, although it is rare even in endemic areas. It can also complicate with acute kidney injury (AKI), graft loss, disease recurrence, hemophagocytic lymphohistiocytosis, and treatment toxicity. This review summarizes key aspects of PDH, including its epidemiology, pathophysiology, clinical and laboratorial features, diagnostic approaches, acute kidney injury, treatment options and prophylaxis among KT recipients with histoplasmosis.</p>

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Histoplasmosis in kidney transplant recipients

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月6日

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  • Osvaldo Mariano Viana Neto,
  • Matheus Alves de Lima Mota,
  • Pedro Yago Lima Mesquita,
  • Evelyne Santana Girão,
  • Janaína de Almeida Mota Ramalho,
  • Terezinha Do Menino Jesus Silva Leitão,
  • Lauro Vieira Perdigão,
  • Luis Arthur Brasil Gadelha Farias,
  • Tainá Veras de Sandes-Freitas,
  • Geraldo Bezerra da Silva Júnior,
  • Roberto da Justa Pires Neto,
  • Maria Alice Sperto Ferreira Baptista,
  • Marlene Antônia dos Reis,
  • Lisandra Serra Damasceno,
  • Elizabeth De Francesco Daher

摘要

Histoplasma capsulatum var. capsulatum is a thermally dimorphic fungus endemic in regions like the Midwestern USA, Africa, and Central/South America. It grows as a mold in the environment and as yeast in human tissues. The disease’s severity and presentation depend mostly on the host’s immunity. In immunocompromised individuals, it often causes progressive disseminated histoplasmosis (PDH), a severe systemic condition. PDH symptoms include pneumonia, enlarged spleen and liver, enteritis, pancytopenia, lymphadenopathy, skin and mucosal lesions, and joint pain, making the diagnosis a challenge. Though more described in Acquired Immunodeficiency Syndrome (AIDS) patients, PDH can also occur in kidney transplant (KT) recipients, although it is rare even in endemic areas. It can also complicate with acute kidney injury (AKI), graft loss, disease recurrence, hemophagocytic lymphohistiocytosis, and treatment toxicity. This review summarizes key aspects of PDH, including its epidemiology, pathophysiology, clinical and laboratorial features, diagnostic approaches, acute kidney injury, treatment options and prophylaxis among KT recipients with histoplasmosis.