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March 1987

Systemic Salmonellosis in Patients With Disseminated Histoplasmosis: Case for 'Macrophage Blockade' Caused by Histoplasma capsulatum

Author Affiliations

From Indiana University School of Medicine, Indianapolis (Drs Wheat and Smith); Massachusetts General Hospital and Harvard Medical School (Drs Rubin and Harris), Boston; Southern Illinois University School of Medicine, Carbondale (Drs Tewari, Chaudhary, and Lascari); and Columbia College of Physicians and Surgeons, New York (Drs Mandell, Garvey, and Goldberg).

Arch Intern Med. 1987;147(3):561-564. doi:10.1001/archinte.1987.00370030165032

• Five patients are described with disseminated histoplasmosis and systemic salmonellosis. Four of these patients were also immunocompromised because of the acquired immunodeficiency syndrome in two patients and renal transplantation in another two patients. Histologic studies in two patients showed histiocytes that were heavily laden with Histoplasma capsulatum yeast-phase organisms. We postulate that diffuse parasitization of the reticuloendothelial system (RES) by Histoplasma organisms may cause "RES blockade," which then prediposes to systemic salmonellosis, as reported in certain other infections and in sickle cell anemia.

(Arch Intern Med 1987;147:561-564).