Fungal epididymitis due to histoplasmosis: A case report
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v81i1.433Keywords:
Epididymitis, Histoplasmosis, Pseudo-tumor, OrchiectomyAbstract
Introduction: Epididymitis due to histoplasmosis is a rare pathology, with only 10 cases reported in a total of 8 articles found up to the end of 2020, in a direct search of international databases (PubMed, Scielo).
It manifests as a pseudo-tumor, causing clinical suspicion of malignancy, and is more frequent in patients presenting with immunodeficiency, especially HIV-AIDS.
A 22-year-old man underwent simple orchiectomy at the surgery service due to a solid tumor adhered to the posterosuperior region of the left testis.
The anatomic pathology service received a specimen labeled as a 5x5x2.5cm left testis and a 3.5x2x2cm nodule, with a dark brown, irregular surface of rubbery consistency. Sectioning revealed a smooth light brown surface with light yellow areas. Diagnosis was epididymitis due to histoplasmosis.
Conclusions: Epididymitis due to histoplasmosis is a rare pathology and its diagnosis is made through microbiology. Once the diagnosed disease is treated, undiagnosed immunodeficiency should be suspected.
References
Kauffman CA, Slama TG, Wheat LJ. Histoplasma capsulatum epididymitis. J Urol. 1981;125(3):434–5. doi: 10.1016/s0022-5347(17)55066-1
Sandoval M, Alsina A, Vidal C, del Sordo M, Muro F, Nora Tiraboschi I, et al. Histoplasmosis genital. Presentación de un caso clínico. Archivos Españoles de Urología. 2003;56(5):462–6.
Darré T, Saka B, Mouhari-Touré A, Dorkenoo AM, Amégbor K, Pitche VP, et al. Histoplasmosis by Histoplasma capsulatum var. duboisii Observed at the Laboratory of Pathological Anatomy of Lomé in Togo. Journal of Pathogens. 2017;2017:e2323412.
Corcho-Berdugo A, Muñoz-Hernández B, Palma-Cortés G, Ramírez-Hernández A, Martínez-Rivera M, León MF, et al. Brote inusual de histoplasmosis en residentes del estado de México. Gac Med Mex. 2011;147(5):377–84.
Randhawa HS, Chaturvedi S, Khan ZU, Chaturvedi VP, Jain SK, Jain RC, et al. Epididymal histoplasmosis diagnosed by isolation ofHistoplasma capsulatum from semen. Mycopathologia. 1995;131(3):173–7. doi: 10.1007/BF01102897
Baig WW, Attur RP, Chawla A, Reddy S, Pillai S, Rao L, et al. Epididymal and prostatic histoplasmosis in a renal transplant recipient from southern India. Transpl Infect Dis. 2011;13(5):489–91. doi: 10.1111/j.1399-3062.2011.00660.x
Monroe, M. “Proceedings: Granulomatous orchitis due to histoplasma capsulatum masquerading as sperm granuloma.”, Journal of Clinical Pathology, V. 27, Núm. 11, 1974, pp. 929–30.
Botero-García C, Faccini-Martínez Á, Uribe E, Calixto O-J, Pérez-Díaz C, Osejo-Diago P, et al. Epididymo-orchitis caused by Histoplasma capsulatum in a Colombian patient. Revista da Sociedade Brasileira de Medicina Tropical. 2017;50:868–70. doi: 10.1590/0037-8682-0267-2017
Guidry JA, Downing C, Tyring SK. Deep Fungal Infections, Blastomycosis-Like Pyoderma, and Granulomatous Sexually Transmitted Infections. Dermatol Clin. 2015;33(3):595–607. doi: 10.1016/j.det.2015.03.019
Kauffman CA. Histoplasmosis: a clinical and laboratory update. Clin Microbiol Rev. 2007;20(1):115–32. doi: 10.1128/CMR.00027-06
