02297nas a2200289   4500008004100000022004200041245009100083210006900174250001000243260001100253300001300264490000700277520137800284653002801662653001001690653006001700653001101760653004201771653001701813653005001830100001401880700001601894700001801910700001801928700001701946856004401963       1965                        eng d  a0008-4409 (Print) 0008-4409 (Linking)00aHistoplasmosis and thrombocytopenic purpura: transmission by renal homotransplantation0 aHistoplasmosis and thrombocytopenic purpura transmission by rena  a23996  cSep 11  a587 - 920 v933 aTwo patients with disseminated histoplasmosis are reported. One patient presented with severe thrombocytopenic purpura and splenomegaly. Histoplasmin skin test, blood and bone marrow cultures and smears, sputum cultures, and chest radiographs were negative for Histoplasma capsulatum. She died on the sixth hospital day from a massive intracerebral hemorrhage. Cardiorespiratory function was maintained until one kidney was removed for homotransplantation. The second patient, with chronic glomerulonephritis and uremia, received the renal homograft from the first patient. Initial signs of homograft rejection developed five days postoperatively. Diffuse thrombocytopenic purpura occurred shortly thereafter. Spores of Histoplasma capsulatum were observed in blood smears, in leukocyte concentrates, and in five-day leukocyte cultures from the blood obtained prior to death. Disseminated histoplasmosis was found in both patients at autopsy. The severe platelet deficit in both cases suggests that systemic histoplasmosis should be considered as a cause of thrombocytopenic purpura.To our knowledge, this is the first reported instance of direct transmission of Histoplasma capsulatum, and must be considered a hazard in homotransplantation.In vitro leukocyte cultures as a method for early diagnosis of certain disseminated fungous infections needs further investigation.10a*Kidney Transplantation10aAdult10aHistoplasmosis / *complications / *etiology / pathology10aHumans10aPurpura, Thrombocytopenic / *etiology10aSplenomegaly10aTransplantation, Homologous / adverse effects1 aHood, A B1 aInglis, F G1 aLowenstein, L1 aDossetor, J B1 aMacLean, L D  uhttp://613633.bywedr.asia/reference/692