Clinical Observation |

Histoplasmosis in Pregnancy:  Case Series and Report of Transplacental Transmission

Stevan P. Whitt, MD; George A. Koch, MD; Belinda Fender, MD; Nathaniel Ratnasamy, MD; E. Dale Everett, MD
Arch Intern Med. 2004;164(4):454-458. doi:10.1001/archinte.164.4.454.
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Although a healthy pregnancy seems to confer an increased susceptibility to systemic fungal infections, to our knowledge, no known association exists in the case of Histoplasma capsulatum. In addition, to our knowledge, transplacental transmission of H capsulatum has not been previously described. We describe a series of patients treated at our institutions between 1997 and 2000 with evidence of transplacental transmission of H capsulatum. Mechanisms of increased risk of histoplasmosis during pregnancy are proposed, although this risk has yet to be proved.

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Figure 1.

Placental histologic features. Clusters of yeast are visible within the stem villi and trophoblast of the placenta (hematoxylin-eosin, original magnification ×400).

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Figure 2.

Grocott modification of Grocott-Gomori methenamine–silver stain of the placenta showing yeast within the villi (original magnification ×1000).

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Figure 3.

Periodic acid–Schiff staining of the placenta. On stained sections, the fungal cell walls and nuclei stained dark pink, with a clear cytoplasm (original magnification ×400).

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