Nasal Septum Perforation Associated to Histoplasmosis: A Retrospective Study

Pineda, Jacinto; Merino-Alado, Rommie; Mata-Essayag, Sofia; Landaeta, Maria Eugenia; Garrido, Liseloth; Rosas, Maria del Mar

doi:10.1590/pboci.2020.090

Jacinto Pineda

Pathological Anatomy Institute “Dr. José Antonio O’ Daly”, Central University of Venezuela, Caracas, Venezuela.

http://orcid.org/0000-0003-0214-9223

Rommie Merino-Alado

Medical Mycology Department “Dr. Dante Borelli”, Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela.

http://orcid.org/0000-0001-5848-275X

Sofia Mata-Essayag Author to whom correspondence should be addressed: Professor Sofia Mata-Essayag, Medical Mycology Department “Dr. Dante Borelli”, Instituto de Medicina Tropical, Universidad Central de Venezuela, Caracas, Venezuela. Phone: +582126053881. E-mail: somae50@hotmail.com.

Medical Mycology Department “Dr. Dante Borelli”, Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela.

http://orcid.org/0000-0003-2012-7036

Maria Eugenia Landaeta

Medical Mycology Department “Dr. Dante Borelli”, Tropical Medicine Institute, Central University of Venezuela, Caracas, Venezuela.

http://orcid.org/0000-0001-9295-7296

Liseloth Garrido

Pathological Anatomy Institute “Dr. José Antonio O’ Daly”, Central University of Venezuela, Caracas, Venezuela.

http://orcid.org/0000-0002-9002-449X

Maria del Mar Rosas

Otorhinolaryngology Department, Universitary Hospital of Caracas, Central University of Venezuela, Caracas, Venezuela.

http://orcid.org/0000-0002-1455-9740

Author to whom correspondence should be addressed: Professor Sofia Mata-Essayag, Medical Mycology Department “Dr. Dante Borelli”, Instituto de Medicina Tropical, Universidad Central de Venezuela, Caracas, Venezuela. Phone: +582126053881. E-mail: somae50@hotmail.com.

Authors’ Contributions

JP Conceptualization, Visualization and Writing - Original Draft Preparation.

RMA Conceptualization, Visualization and Writing - Original Draft Preparation.

SME Conceptualization, Visualization, Writing - Original Draft Preparation and Supervision.

MEL Data Curation and Supervision.

LG Data Curation and Investigation.

MMR Resources and Data Curation.

All authors declare that they contributed to critical review of intellectual content and approval of the final version to be published.

Academic Editors: Alessandro Leite Cavalcanti and Wilton Wilney Nascimento Padilha

Conflict of Interest

The authors declare no conflicts of interest.

Variables	N	%
Gender
Female	14	63.6
Male	8	36.4
Residence
Urban Area	15	68.2
Rural Area	5	22.7
Unknown	2	9.1
Alcoholism
Yes	2	9.1
No	22	90.9
Smoking
Heavy Smoker	2	9.1
No	13	59.1
Missing	7	31.8
Occupation Known
Farmer	7	31.8
Builder	1	4.5
Housewife	5	22.7
Others	7	31.8
Unknow	2	9.1

Signs/Symptoms^* * Some patients had more than 1 sign/symptom.	N	%
Epistaxis	14	63.6
Crustings	12	54.5
Fever	5	22.7
Dyspnoea	6	27.2
Cough	3	13.6
Others	6	27.2

Comorbidities	N	%
HIV/AIDS	2	9.1
Lupus Erythematosus	3	13.6
Wegener Granulomatosis	2	9.1
Paracoccidioidomycoses	2	9.1
Arterial Hypertension	2	9.1
Diabetes	2	9.1
Chronic Renal Failure	1	4.5
None	9	40.9

No	Sex	Age (Years)	Risk Factors	Clinical Presentation	Lesions	Diagnosis	Treatment	Comorbidity	Chest X Ray	Follow up
1	F	27	Contact with landslide	Epistaxis, nose wound with crusts	NSP	Biopsy, culture and direct examination	Itraconazole V.O 400 mgs 1 year	None	Interstitial pneumonitis	Improvement
2	F	20	Farming	Epistaxis, nose wound with crusts, cough, dyspnea, weight loss, cutaneous lesions	NSP	Direct examination	Itraconazole V.O 400 mgs 1 year	HIV/AIDS and PCM	Interstitial pneumonitis	Dead
3	F	27	Barnyard fowl contact	Epistaxis, cough, dyspnea	NSP	Biopsy, culture	Itraconazole V.O 400 mgs 1 year	None	Interstitial pneumonitis	Dead
4	M	38	Cave tourism	Epistaxis, productive cough, dyspnea	NSP	Biopsy and direct examination	Itraconazole V.O 400 mgs 1 year	None	Interstitial pneumonitis	Improvement
5	M	73	Builder, treatment with oral steroids and methotrexate	Epistaxis, nose wound with crusts, fever, dyspnea, nasal discharge, cephalea	NSP	Culture and direct examination	Itraconazole V.O 400 mgs 1 year	Granulomatosis with polyangiitis	Interstitial pneumonitis	Improvement
6	M	47	Farming, alcoholism, barnyard fowl contact	Nose wounds with crusts, fever, adeno and splenomegaly, cough, dyspnea	NSP	Culture and direct examination	Itraconazole V.O 400 mgs 1 year	None	Tumor mass upper right lobe and pulmonary infiltrates	Improvement
7	M	98	Unknown	Epistaxis	NSP	Biopsy	Unknown	None	Unknown	Unknown
8	F	33	Treatment with anti-TNFα	Epistaxis	NSP	Biopsy	Unknown	SEL	Unknown	Unknown
9	F	75	Unknown	Nose wounds with crusts	NSP	Biopsy	Unknown	DM II	Unknown	Dead
10	F	48	Unknown	Cacosmia, nose wound with crusts	NSP	Biopsy	Itraconazole V.O 400 mgs 1 year	SEL	Unknown	Unknown
11	F	75	Treatment with steroids	Epistaxis	NSP	Biopsy	Unknown	Granulomatosis with polyangiitis	Unknown	Unknown
12	F	29	Unknown	Nose wounds with crusts	NSP	Biopsy	Unknown	HIV/AIDS	Unknown	Unknown
13	M	56	Unknown	Epistaxis and pain	NSP	Biopsy	Unknown	Unknown	Unknown	Unknown
14	F	78	Treatment with steroids	Pain	NSP	Biopsy	Unknown	CKD	Unknown	Unknown
15	F	39	Treatment with Etanercept^© (TNFα blocker)	Epistaxis	NSP	Biopsy	Itraconazole V.O 400 mgs 1 year	None	Normal	Improvement
16	M	49	Contact with soil dust	Epistaxis, nose wound with crusts	NSP	Biopsy	Itraconazole V.O 400 mgs 1 year	None	Normal	Improvement
17	M	51	Poultry man	Epistaxis, nasal obstruction	NSP	Direct examination	Itraconazole V.O 400 mgs 1 year	None	Normal	Improvement
18	F	70	Cave tourism, farming	Epistaxis, nose wounds with crusts, dyspnea	NSP	Serology, culture and biopsy	Itraconazole V.O 400 mgs 1 year	AHT	Interstitial pneumonitis	Improvement
19	F	20	Farming	Cacosmia, nose wounds with crusts, dyspnea, weight loss, fever, hepato-splenomegaly	NSP and palate perforation	Biopsy	Amphotericin B	None	Interstitial pneumonitis	Dead
20	F	47	Treatment with Treatment with anti-TNFα, heavy smoker, barnyard fowl contact	Epistaxis, fever	NSP	Biopsy	Itraconazole V.O 400 mgs 1 year	LES	Unknown	Unknown
21	F	70	Cave tourism	Wight loss, dyspnea, crusting, rhinitis	NSP	Biopsy	Itraconazole V.O 400 mgs 1 year	PCM	Interstitial pneumonitis	Unknown
22	M	46	Contact with soil dust, smoker and alcoholism	Wight loss, dyspnea, crusting, hepato-splenomegaly cervical adenomegaly	NSP	Biopsy	Itraconazole V.O 400 mgs 1 year	DM II and AHT	Unknown	Unknown

[1] Author to whom correspondence should be addressed: Professor Sofia Mata-Essayag, Medical Mycology Department “Dr. Dante Borelli”, Instituto de Medicina Tropical, Universidad Central de Venezuela, Caracas, Venezuela. Phone: +582126053881. E-mail: somae50@hotmail.com.

Brasil

Brasil

Nasal Septum Perforation Associated to Histoplasmosis: A Retrospective Study

Abstract

Objective:

Material and Methods:

Results:

Conclusion: