Antifungal Drugs

Chapter 36 Antifungal Drugs


Pathogenic Fungal Infection of the Gastrointestinal Tract

Histoplasma capsulatum


Organism identification is required for definitive diagnosis. The most common means of organism identification is cytology. Cytology from affected tissue reveals pyogranulomatous inflammation, often with numerous small, round to oval intracellular yeast cells (2 to 4 µm in diameter) characterized by a basophilic center and a light halo. Exfoliative cytology during colonoscopy (or upper GI endoscopy) is considered useful in diagnosing the disease.5 Histopathology is helpful if cytology is nondiagnostic or inconclusive. Multiple endoscopic colonic biopsies are usually sufficient to diagnose the disease. The yeast form does not stain well with routine hematoxylin and eosin stains, periodic acid-Schiff and Gomori methenamine silver stain are often used. Fungal culture from affected tissue can be used for diagnosis, but is rarely needed in clinical cases. Currently available serologic tests have poor specificity and sensitivity.4

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Jul 10, 2016 | Posted by in INTERNAL MEDICINE | Comments Off on Antifungal Drugs

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