Histoplasmosis other diagnostic studies
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Other Diagnostic Studies
Microscopy
- The gold standard for diagnosis of histoplama infection is direct visualization of the oviod yeast cells in the tissue samples and body fluid specimen.
- Histoplasma capsulatum is characterized by a budding yeast connected with a narrow base and is mostly identified within the macrophages and monocytes.
- In immunocompetent people, immune response by the macrophages results in the formation of a granuloma and the yeast forms are demonstrated within the histiocytes in the granuloma. However in patients with disseminated infection the yeast forms can be demonstrated in the histiocytes scattered throughout the organ and are not confined to the granulomas alone.
- Different stains such as the gram stain, Giemsa stain, Hematoxylin-eosin stain, Mucicarmine stain, PAS stain and Wright-Giemsa stain are useful for demonstration of the granulomas and the yeast forms in the tissue specimen or body fluid samples.
Culture
- Culture is positive 50% to 85% patients with disseminated histoplasmosis and chronic pulmonary histoplasmosis.
- Culture takes 4 weeks to grow and the mold appears as a suede-like or cottony mycelium. Microscopic examination of the mold demonstrate characteristic large, rounded tuberculate macroconidia.
Antigen Testing
- Antigen testing is an useful method for rapid diagnosis of histoplasma infection. Galactomannan antigen can be detected in the blood or urine samples and is positive in majority of patients with acute pulmonary histoplasmosis and disseminated histoplasmosis.
Gallery
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Magnified 125X, "digested", then stained using a fluorescent antibody-staining technique, this photomicrograph reveals the presence of Histoplasma capsulatum antigens in this human lung tissue specimen. From Public Health Image Library (PHIL). [1]
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Magnified 125X, "digested", then stained using a fluorescent antibody-staining technique, this photomicrograph reveals the presence of Histoplasma capsulatum antigens in this human lung tissue specimen. From Public Health Image Library (PHIL). [1]
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Magnified 1250x, this H&E-stained liver tissue specimen reveals the presence of yeast-staged Histoplasma capsulatum fungal organisms inside a number of phagocytic macrophages. From Public Health Image Library (PHIL). [1]
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This Giemsa-stained photomicrograph reveals a histiocyte within which numerous Histoplasma capsulatum fungal organisms in their yeast-stage of development were contained. From Public Health Image Library (PHIL). [1]
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This photomicrograph reveals the presence of Histoplasma capsulatum fungal organisms in any unknown specimen, which were in the organism's yeast phase, displaying numerous microconidia. From Public Health Image Library (PHIL). [1]