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Presentation and Treatment of Histoplasmosis in Pediatric Oncology Patients: Case Series and Review of the Literature

Hess, Jennifer DO, MS; Fondell, Andrew DO; Fustino, Nicholas MD; Malik, Jeff MD; Rokes, Christopher MD

Journal of Pediatric Hematology/Oncology: March 2017 - Volume 39 - Issue 2 - p 137–140
doi: 10.1097/MPH.0000000000000588
Clinical and Laboratory Observations

Histoplasmosis is an endemic fungus in several regions of the United States. The diagnosis and treatment of this infection can be challenging in pediatric oncology patients. We present 5 patients diagnosed with histoplasmosis while receiving treatment at a midsize pediatric oncology center in Iowa. Two cases occurred in patients with acute lymphoblastic leukemia and 3 cases in patients with solid tumors. All patients were treated with antifungal therapy and demonstrated excellent clinical response. Histoplasmosis should be considered as a potential cause of nonspecific febrile illness, pulmonary masses, and bone marrow suppression in immunocompromised patients in endemic regions. Prompt and accurate diagnosis can facilitate timely antifungal therapy and avoidance of prolonged hospital stays, invasive testing, unnecessary antibiotics, and unwarranted anticancer therapies.

*Blank Children’s Hospital Pediatric Residency Program

Blank Children’s Cancer and Blood Disorders Center

Iowa Pathology Associates, Des Moines, IA

The authors declare no conflict of interest.

Reprints: Jennifer Hess, DO, MS, Pediatric Residency Program, 1200 Pleasant Street, Des Moines, IA 50309 (e-mail:

Received December 10, 2015

Accepted April 18, 2016

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