{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:17:09Z","timestamp":1790972229666,"version":"4.1.0"},"reference-count":6,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2003,1,1]],"date-time":"2003-01-01T00:00:00Z","timestamp":1041379200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"published-print":{"date-parts":[[2003]]},"abstract":"<jats:p>Acute histoplasmosis is usually a benign, self-limited infection in endemic areas. Since protection against &lt;i&gt;Histoplasma capsulatum&lt;\/i&gt; infection requires specific, cell-mediated immunity, histoplasmosis is well documented in patients with acquired T cell deficiencies e.g. due to HIV infection. We report here for the first time a case of pleural effusion due to &lt;i&gt;H. capsulatum&lt;\/i&gt; infection in a patient with idiopathic CD4 lymphocytopenia (ICL). A 25-year-old woman presented with chest pain, dyspnea on exertion and a moderate weight loss. Chest X-ray showed a large left pleural effusion, and thoracentesis yielded an exudate. Histologic examination of pleural biopsies identified &lt;i&gt;H. capsulatum&lt;\/i&gt;. Laboratory tests revealed lymphocytopenia with low CD4+ T cell counts (&lt;100\/\u00b5l) and a decreased CD4\/CD8 ratio. Serology, including HIV, was repeatedly negative. The diagnosis of pleural effusion due to &lt;i&gt;H. capsulatum&lt;\/i&gt; infection in a patient with idiophatic ICL was established. There was no evidence of any other opportunistic infection. Treatment with itraconazole was initiated and pleural effusion resolved within 2 weeks of treatment. Moreover, the patient was found to have idiopathic thrombocytopenic purpura, as confirmed by the detection of autoantibodies against thrombocytes. In a 1-year follow-up, the patient remained asymptomatic without relapse or any new infection. Treatment with itraconazole was given for 12 months. Because of persistent CD4+ T cell counts below 100\/\u00b5l, prophylactic antibiotic treatment is continued.<\/jats:p>","DOI":"10.1159\/000068426","type":"journal-article","created":{"date-parts":[[2003,4,15]],"date-time":"2003-04-15T21:05:40Z","timestamp":1050440740000},"page":"118-122","source":"Crossref","is-referenced-by-count":19,"title":["Pleural Effusion due to &lt;i&gt;Histoplasma capsulatum&lt;\/i&gt; and Idiopathic CD4 Lymphocytopenia"],"prefix":"10.1159","volume":"70","author":[{"given":"C.","family":"Kortsik","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Elmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Tamm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2003,2,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199302113280602"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(92)92359-N"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199302113280604"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199302113280601"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199302113280603"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199302113280604"}],"container-title":["Respiration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/68426","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/68426","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:33:45Z","timestamp":1745465625000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000068426"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2003,2,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000068426","archive":["Portico"],"relation":{},"ISSN":["0025-7931","1423-0356"],"issn-type":[{"value":"0025-7931","type":"print"},{"value":"1423-0356","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003]]}}}