{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:06:30Z","timestamp":1756339590380,"version":"3.44.0"},"reference-count":17,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,10,26]]},"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>Disseminated histoplasmosis is a life-threatening condition in immunocompromised patients. The majority of healthy persons have benign disease not requiring treatment. However, in persons living with HIV, mortality is high and accurate diagnosis is paramount. We present a case of a 48-year-old HIV-positive woman who presented with haematuria and flank pain. She had a history of recurrent urinary tract infection and nephrolithiasis with obstructive hydronephrosis. During cystoscopy, a bladder lesion was found. Pathological evaluation demonstrated abundant intracellular organisms with apparent budding. Subsequent urine histoplasma antigen was negative. Given the high index of suspicion for histoplasmosis based on the surgical pathology findings and epidemiological history, the patient was started immediately on antifungal therapy. One week later, PCR results of the bladder lesion confirmed the presence of <jats:italic>Histoplasma capsulatum<\/jats:italic>. This case highlights a rare presentation of genitourinary histoplasmosis and the utility of surgical pathology evaluation and PCR for diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2021-243375","type":"journal-article","created":{"date-parts":[[2021,11,12]],"date-time":"2021-11-12T11:30:12Z","timestamp":1636716612000},"page":"e243375","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Disseminated genitourinary histoplasmosis in a patient with AIDS with negative urine antigen testing"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2035-6824","authenticated-orcid":false,"given":"Candice Theodora","family":"Joseph","sequence":"first","affiliation":[{"name":"Infectious Disease and Global Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Feely","sequence":"additional","affiliation":[{"name":"Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Iovine","sequence":"additional","affiliation":[{"name":"Infectious Disease and Global Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,11,12]]},"reference":[{"key":"2025082711442252000_14.11.e243375.1","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1378\/chest.29.6.649","article-title":"Geographic variation in the prevalence of histoplasmosis sensitivity","volume":"6","author":"Manos","year":"1956","journal-title":"Icon Dis Chest"},{"key":"2025082711442252000_14.11.e243375.2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00027-06"},{"key":"2025082711442252000_14.11.e243375.3","doi-asserted-by":"publisher","DOI":"10.1086\/379770"},{"key":"2025082711442252000_14.11.e243375.4","doi-asserted-by":"publisher","DOI":"10.1086\/313824"},{"key":"2025082711442252000_14.11.e243375.5","unstructured":"New Panel on Opportunistic Infections in Adults and Adolescents with HIV . Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the centers for disease control and prevention, the National Institutes of health, and the HIV medicine association of the infectious diseases Society of America. Histoplasmosis 2019."},{"key":"2025082711442252000_14.11.e243375.6","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1945.00210250008001"},{"key":"2025082711442252000_14.11.e243375.7","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/S0022-5347(17)61204-7","article-title":"Genitourinary tract involvement with systemic mycosis","volume":"107","author":"Orr","year":"1972","journal-title":"J Urol"},{"key":"2025082711442252000_14.11.e243375.8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.5455\/msm.2017.29.17-20","article-title":"The most frequent isolates from outpatients with urinary tract infection","volume":"29","author":"Vranic","year":"2017","journal-title":"Mater Sociomed"},{"key":"2025082711442252000_14.11.e243375.9","doi-asserted-by":"publisher","DOI":"10.1086\/313904"},{"key":"2025082711442252000_14.11.e243375.10","doi-asserted-by":"publisher","DOI":"10.1086\/313583"},{"key":"2025082711442252000_14.11.e243375.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2008.05.006"},{"key":"2025082711442252000_14.11.e243375.12","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir435"},{"key":"2025082711442252000_14.11.e243375.13","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1007\/s11046-009-9182-z","article-title":"Histoplasma capsulatum recovery from the urine and a short review of genitourinary histoplasmosis","volume":"167","author":"Pasqualotto","year":"2009","journal-title":"Mycopathologia"},{"key":"2025082711442252000_14.11.e243375.14","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-199011000-00004"},{"key":"2025082711442252000_14.11.e243375.15","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00673-11"},{"key":"2025082711442252000_14.11.e243375.16","doi-asserted-by":"publisher","DOI":"10.1086\/521259"},{"key":"2025082711442252000_14.11.e243375.17","doi-asserted-by":"crossref","first-page":"1646","DOI":"10.1093\/ofid\/ofw172.1346","article-title":"Comparison of posaconazole and itraconazole for treatment of histoplasmosis","volume":"3","author":"Bobbili","year":"2016","journal-title":"Open Forum Infectious Disease"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243375","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:44:28Z","timestamp":1756320268000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243375"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":17,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,12]]},"published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1136\/bcr-2021-243375"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243375","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}